Since the changes planned for St. Andrews Hospital were announced, Lincoln County Healthcare has been working internally to resolve the issues associated with implementing those changes. Last week, CEO Jim Donovan, Hospital Operations Vice President Cindy Leavitt and Physician Services Vice President Stacey Miller provided an update.

Lincoln County Healthcare will close St. Andrews Hospital’s emergency room and skilled nursing bed wing in April 2013. Because of those changes, St. Andrews will no longer be a hospital and will shift its emphasis to primary and outpatient care.

Leavitt and Miller lead the healthcare organization’s internal transition team. Subgroups, which meet biweekly, have been formed to address specific issues. A community advisory committee will be launched in the next week.

New services

Donovan said Lincoln County Healthcare is considering new services at Boothbay Harbor, such as a retail pharmacy located at the Family Care Center, a cafe and additional skilled nursing beds at St. Andrews Village. Plans for new services will be developed with community advisory group input. Some, such as a pharmacy and nursing beds, are subject to state regulatory review.

Donovan said the organization’s focus is on how best to use all the space at the St. Andrews campus, rather than how to fill the hospital bed wing.

“Replacing the swing service with another service built around people lying in beds is not going to work. It’s too small to be sustainable,” Donovan said. He said their emphasis is to provide space for growing programs, such as occupational and physical therapy, and to support primary and senior care.

A main concern of local residents has been the loss of some community end-of-life care with the swing bed unit closing. Miller and Leavitt said they are working to provide that care at St. Andrews Village. Leavitt said St. Andrews Village is licensed for six skilled nursing beds now, but they are not currently set up or staffed to fill the end-of-life care void that will be created by the hospital closing.

Lincoln County Healthcare will seek approval from the Department of Health and Human Services for more skilled nursing beds to address this need she said. Leavitt said end-of-life care provided at Miles Memorial Hospital will continue.

Ambulance service

Donovan said a draft proposal to improve the Boothbay Regional Ambulance Service’s capabilities, which addresses finances, personnel, equipment and training needs, has been developed. He hopes to present a final plan, dependent on additional input from the ambulance service, to the Board of Trustees for approval at their October meeting.

Community advisory group

Lincoln County Healthcare has invited several community members to join a community advisory group that will meet monthly. Miller said that it is “not a closed group” but it will be focusing on transition plans, development of new services and communication. The town task force decided early in its process not to join in this effort.

Job losses

Earlier estimates that 50 jobs would be lost were an overestimate, Leavitt said. On October 3, she provided a list of the 29 employee positions slated to end in April. Expected job losses include 14 registered nurses, 4 certified nurse assistants, 5 cooks, 2 secretaries, 1 cardiopulmonary therapist, 1 manager, 1 pharmacist and 1 education technician.

Leavitt said Lincoln County Healthcare’s human resources department has been working with each employee to find new positions within the organization and on cross-training employees for different positions. Donovan said the healthcare organization is paying retention bonuses to employees who stay on during the transition period.

Urgent Care

Leavitt said the urgent care subgroup is looking specifically at what it means to be an urgent care facility, addressing reimbursement and regulatory questions and will visit other urgent care facilities in the state.

The Department of Health and Human Services sent a letter to MaineCare recipients in August notifying them that treatment at Ambulatory Surgical Centers would no longer be covered under MaineCare. According to DHHS, this letter referred to the 26 ambulatory surgical centers in Maine that provide elective outpatient surgeries and not to urgent care centers. MaineCare does cover appropriate treatment at urgent care centers.

St. Andrews Village

Donovan said there will be no changes for St. Andrews Village residents although the Village’s place in Lincoln County Healthcare’s organizational structure will change. St. Andrews Village is presently organized under St. Andrews Hospital; Donovan said it will not be reorganized under Miles Hospital.

Regulatory changes

Meeting licensing and regulatory needs will be a large part of the healthcare organization’s work in the coming months, but those types of organizational and licensing changes are less likely to be noticed by patients.

Donovan said Lincoln County Healthcare plans to simplify its organizational structure, which now consists of five separate corporations, but those plans have not been fully developed. The Department of Health and Human Services has oversight and licensing authority.

Sue Mello can be reached at 844-4629 or sumello@boothbayregister.com.