A car drives along the entrance road to Calais Regional Hospital on Aug. 21, 2019. Credit: Bill Trotter / BDN

A judge has dismissed a court-appointed watchdog who was overseeing the patient care at Calais Regional Hospital after state officials found the facility had made a number of improvements since last spring.

That ombudsman was appointed to monitor the hospital early in April as part of its ongoing Chapter 11 bankruptcy proceeding. The court agreed to the appointment after state health officials raised alarm about the Down East hospital’s ability to handle the spread of the coronavirus after an emergency room doctor was unable to intubate a patient who was having trouble breathing.

But at the beginning of October, state officials proposed terminating the ombudsman, a health care consultant based in Belfast, after his reports showed patient care was not declining and that the hospital had made a number of improvements. Last week, U.S. Bankruptcy Judge Michael Fagone agreed to the termination.

In his initial report in June, ombudsman Jeffrey Brown identified several shortcomings in patient care at Calais Regional Hospital, including delays for those seeking breast cancer screenings, billing mistakes that were time-consuming to fix and poor communication between management and frontline workers.

As Brown was putting together that first report, the hospital warned it might have to close by the summer without outside funding and lay off 10 percent of its workforce, due to steep revenue shortfalls stemming from delaying nonessential services during the coronavirus pandemic.

The hospital has not confirmed how many workers it laid off in late April, and Brown did not specifically reference the layoffs in his report, but he did warn the hospital that cutting staff and programs could “compromise patient care quality and safety.”

More recently, Brown found that the hospital was updating its processes for engaging staff and had created a new position to improve its scheduling of procedures and tests, according to court records. A director of quality management who was hired last spring has been helping the hospital comply with regulations, and a registered nurse has been recruited to support those efforts, Brown said in his last report on Sept. 30.

Additionally, Brown found that the hospital — working with a Tennessee-based contractor, Envision Physician Services, hired early this year to employ its emergency room doctors — has recruited a stable set of ER physicians and a director to conduct monthly reviews of their work.

Envision replaced a Maine-based company that had offered a similar service at Calais Regional Hospital for higher fees. The bankruptcy court specifically tasked the ombudsman with reviewing Envision’s role after one of its doctors was unable to intubate a patient who was having trouble breathing last February, prompting the hospital to call in local paramedics to complete the lifesaving service.

A spokesperson for Calais Regional Hospital didn’t respond to a request for comment.

The facility entered Chapter 11 bankruptcy last year after struggling to pay back millions in debts and having to cut some programs in recent years. After warning it might have to close by the summer, the hospital has since received at least $3.7 million in federal coronavirus relief funds.

In April, the hospital sued the federal government seeking to overturn a rule that prevented businesses in bankruptcy from applying for funding under the federal Paycheck Protection Program. After a judge dismissed that suit, the hospital briefly proposed exiting bankruptcy in late July so it could apply for the program, but withdrew that proposal about a week later.