BOOTHBAY HARBOR, Maine — The Maine Department of Health and Human Services has rescinded its requirement that an urgent care center on Boothbay peninsula remain open around the clock.
In a Friday letter, DHHS Commissioner Mary Mayhew lifted the requirement, one of three conditions her department imposed in May as part of a broader approval of LincolnHealth’s plan to merge Miles Memorial Hospital in Damariscotta and St. Andrews Hospital in Boothbay Harbor, which shares a campus with the urgent care center.
LincolnHealth asked DHHS to reconsider the condition before enforcing it, which led to an Aug. 11 public hearing.
LincolnHealth presented new information at the hearing that demonstrated 24-hour operation of an urgent care clinic “would not lower costs or improve access or efficiency for the system of health care in the region,” Mayhew wrote.
DHHS originally required that the health system maintain those hours for at least 18 months as part of the agency’s certificate of need review, which regulates the expansion of health care facilities in Maine.
The health system argued that staffing the clinic around the clock would lead to annual operating losses of more than $600,000, at a cost of more than $1,000 per patient.
Mayhew accepted LincolnHealth’s position that the projected expense failed to justify the volume of patients the urgent care center would attract. At best, the facility would “only improve accessibility for an estimated 800 patients,” who can be served by the existing emergency department in Damariscotta,” she wrote.
While the Boothbay Region Health and Wellness Foundation suggested that LincolnHealth implement an alternative staffing model, relying on mid-level providers and fewer employees, Mayhew concluded that the approach was unlikely to improve the facility’s finances and that any savings would fail to offset the lower quality of care.
The urgent care center will continue operating from 8 a.m. to 8 p.m., seven days a week.
Citing low patient counts and financial pressures, the Lincoln County health system closed the St. Andrews emergency room — the only one on the Boothbay peninsula — in October 2013. The hospital converted into an urgent care center, without an emergency room, inpatient services or the ability to accommodate critical care patients.
Operating last year for 12 hours a day, the facility treated 3,735 patients, more than the previous year when it was open as an emergency department, LincolnHealth President Jim Donovan said in a statement.
“We deeply appreciate Commissioner Mayhew’s willingness to re-examine the conditions of her Certificate of Need approval, and her decision to rescind the condition requiring an additional 12 hours of urgent care service delivery at the St. Andrews campus,” Donovan said. “In close partnership with EMS services and providers, we strongly believe we have maintained accessible, high-quality emergency and urgent care services for everyone in Lincoln County.”
Residents opposed to the emergency room closure organized a task force and spoke out against the plan.
Friday’s decision disappointed but didn’t surprise community members because their voices have been “ignored and blocked at every step,” Patty Seybold, president of the Boothbay Region Health and Wellness Foundation, said.
“We’re dismayed that Mary Mayhew has backed down on her requirement to provide 24-hour urgent care service on the peninsula,” she said.
While Mayhew’s decision marks the end of the road for the group’s attempts to save St. Andrews hospital, more work remains to improve health and wellness in the region, she said. Opponents hope LincolnHealth will speedily submit a new application to DHHS to add skilled nursing beds to replace those lost at St. Andrews, she said. Skilled nursing beds typically serve patients who no longer need acute hospital care but aren’t well enough to return home.
The two other conditions DHHS imposed upon approving the merger — which creates a single hospital with two campuses — remain in place. LincolnHealth must update the state on its application to retain federal status as a critical access hospital and annually report on its efforts to combat chronic disease in Lincoln County.
LincolnHealth is a member of MaineHealth, the parent organization to Maine Medical Center in Portland.