February 24, 2020
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Houlton hospital adjusts to meet patient needs

HOULTON, Maine — With the needs of its patients changing, officials at Houlton Regional Hospital on Wednesday announced plans to reorganize the facility.

The changes include eliminating the intensive care unit — which hospital officials said houses a dwindling number of patients — and instead creating beds for patients who need an “intermediate level” of care.

No jobs or patient bed space will be lost under the plan, Tom Moakler, the hospital’s chief executive officer, said Wednesday. The hospital, which has 25 acute care beds and 28 skilled nursing home beds, employs 450 people.

Moakler said that over the past few years, the hospital’s ICU population has dwindled.

Today, patients from the area who require that level of care often are sent to the larger Eastern Maine Medical Center in Bangor.

The hospital now sees a need for intermediate-level care beds, for patients who don’t require the level of care provided by the ICU but still need a greater level of care than someone who enters the facility for medical or surgical needs.

Moakler said that the shift in needs became apparent after HRH was designated as a “critical access” hospital in 2004. The designation made the facility eligible for higher Medicaid and Medicare reimbursements.

The status limits the services that HRH can provide, but it also boosts revenues and allows the facility to survive and provide superior medical care.

The average length of a patient’s stay at such hospitals can’t exceed four days, and people who need the level of care provided by the ICU are usually in the hospital for a long period of time.

With more of the critical patients being sent to Bangor, ICU nurses have been seeing fewer patients.

When hospital administrators saw this, they decided to create the five intermediate-level beds that will be attached to the hospital’s medical and surgical wing.

Moakler and Doris Kennedy, the director of nursing, said the changes would be barely noticeable to patients.

In the hospital’s ICU, nurses can view all of the patients. This will not change when the intermediate beds are created, as each of those rooms will have cameras so the nursing staff can continue to see the patient.

“There also will be more privacy for those patients,” Kennedy said, “because ICU patients currently don’t have a bathroom in their room. The patients in the intermediate-care beds will.”

Nurses working on the medical-surgical unit will receive extensive in-service training in how to care for intermediate-level patients, she said.

The hospital plans to turn the ICU into space for case management and social services staff members. Moakler said he is looking to receive approval for the plan from the state Department of Health and Human Services Division of Licensing and Regulatory Services.

Once that is accomplished, the transition could take place by May 1.

“There are several benefits to this change,” Moakler said. “We always had a hard time recruiting ICU nurses, and now we won’t have to. This will not impact our quality of care, and no jobs or bed space will be lost.”

He added that simply shutting down the ICU would have put people out of work and resulted in fewer patient beds.

He and Kennedy acknowledged that there were “mixed feelings” among the nursing staff about the decision, but Moakler said he felt that the hospital had crafted a creative way to serve the changing patient population.

“Everyone reacts differently to change, but again, no one is losing their job and our patients will be better served,” he said Wednesday. “Given where health care is today, this makes sense.”

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