Lincoln County Health Care has been granted a certificate of need by the state related to the merger of St. Andrews Hospital in Boothbay Harbor and Miles Memorial Hospital in Damariscotta, but it comes with strings attached.
With the closure of the emergency department at St. Andrews in October 2013, that facility and Miles merged to become the new, two-campus hospital called LincolnHealth, according to spokesman Scott Shott.
According to John Martins, a spokesman for the Maine Department of Health and Human Services, a state review and a certificate of need is required for acquisitions, mergers, and new construction of health care services or facilities.
DHHS Commissioner Mary Mayhew granted the conditional approval for certificate of need for the St. Andrews-Miles merger in a letter to the company dated May 27.
The conditions outlined in Mayhew’s letter need to be agreed upon and met for the certificate to remain valid, according to Martins.
The biggest requirement is LincolnHealth must start providing 24-hour urgent care within three months of Mayhew’s letter. Since the merger, LincolnHealth has been providing urgent care at the St. Andrews Campus, but only from 8 a.m. to 8 p.m., Shott said.
“Urgent care is non-emergency care that needs to be done soon,” Shott said. Life-threatening situations like a stroke or heart-attack need emergency care, whereas a cut arm, broken finger, or ear infection likely need only urgent care, he said.
“For the most part, if you’re in a position to drive yourself to the emergency room or have a friend to drive you, that’s sort of an indicator it’s urgent care you need, not emergency care,” he said.
“I have determined that the ordinary economic development of health care for the Boothbay region would be adversely affected and this specific application would have to be denied if the applicant who provided acute emergency care was not required to maintain an appropriate urgent care presence,” Mayhew said in her letter.
LincolnHealth will be required to provide the urgent care service for at least three years, unless they can demonstrate utilization has not been adequate to meet certain cost benchmarks. Even so, the earliest the service could be interrupted would be 21 months from now.
Shott said LincolnHealth was “surprised” by Mayhew’s urgent care requirement but the hospital is committed to working with the state.
“Our analysis, shared with the Department of Health and Human Services, concluded that an urgent care center operating 12 hours per day was indeed in the best health interests of the community, and we are working to understand the requirement by the Certificate of Need Unit for this additional investment in service delivery,” Shott said in an email.
“Having just received the commissioner’s approval letter, we are working diligently to evaluate the intent of the conditional approval and are weighing our options as we fulfill our mission to ‘ensure access to high quality, patient-centered and affordable health care,'” Shott said.
Patty Seybold, board president of the Boothbay Region Health & Wellness Foundation, sent out a press release May 30 lauding the urgent care condition.
“The members of this community have fought hard for 23 months to regain 24 hour emergency care for our peninsula,” said Seybold. “We lobbied in Augusta, we met with the Governor and the Attorney General, we were finally given the opportunity to have a public hearing to provide testimony to the DHHS (but only after our [emergency room] was shut down and our hospital merged).”
“We are gratified that Commissioner Mayhew listened to the voices of the customers – our year round population, our large retiree population, and our multi-generational seasonal residents – and agreed with us that 24-hour urgent care is required on our peninsula,” she said.
Along with the urgent care requirements, Mayhew’s conditional approval of the certificate of need includes required reporting on LincolnHealth’s community service programs to reduce things like smoking-related diseases and diabetes, and on the transfer of St. Andrews critical access hospital designation to LincolnHealth.
