CALAIS, Maine — Calais Regional Hospital will close its obstetrics department, a move that will leave Washington County with just one hospital fully equipped to deliver newborns.
Since 2007, the hospital’s delivery rate has dropped from more than 100 births annually to just 60 last year, according to a statement from Calais Regional. That decline, coupled with a shortage of nursing staff, lead to “heavy financial losses” in the obstetrics department that the board determined the hospital can no longer sustain, the hospital said.
Newborn deliveries will be phased out by the end of 2017.
“A hospital’s services must always be provided to meet a community’s health care needs, and the demand for obstetrics just isn’t sufficient to maintain the service. Shouldering the significant costs associated with the program places an enormous strain on our financial operations,” Ron McAlpine, CRH board chairman, said in the statement. “This is a difficult decision that the board has not taken lightly, but we must take action to ensure the hospital remains financially viable so it can continue to serve our community in the years to come.”
A union that represents about 80 nurses in Calais said hospital CEO Rod Boula informed employees last week that the obstetrics department would close on Jan. 1, 2018.
The “dangerous decision” by the hospital will leave its entire service area, which stretches to Baileyville, Eastport, Dennysville, Pembroke and the rest of northeastern Washington County, without essential care, the union said in a statement. Down East Community Hospital, located 40 miles away in Machias, is the closest alternative medical center with an obstetrics unit.
“Our community depends on us. How in the world can we force expectant mothers to go far outside of our community for the essential services that we provide?” Melanie Howard, an OB RN, said in the union’s statement.
The nurses are represented by the Maine State Nurses Association/National Nurses Organizing Committee/National Nurses United.
The hospital did not respond to several follow-up questions about the potential closure, including how much money the unit is losing.
No staff layoffs are planned as the result of the closure of the obstetrics unit, with affected staff given the option to relocate to other departments, according to the hospital’s statement.
Staff in the emergency department will be trained and equipped to handle emergency deliveries and the hospital is “actively pursuing opportunities to offer both prenatal and gynecological services in the local community.”
Other local primary care providers offer women’s health services, such as mammography, bone density scans, ultrasounds and laboratory testing, according to the hospital. Efforts are also underway to recruit additional providers in specialty areas, including pulmonology, urology and oncology, it said.
Calais is not alone in eliminating its labor and delivery services. Blue Hill Memorial Hospital closed its obstetrics unit in 2009, and Penobscot Valley Hospital in Lincoln followed suit in 2014.
Nationally, a growing number of rural hospitals are shuttering their obstetric departments, as the units are expensive to operate and hospitals often struggle to find doctors and nurses to staff them. Between 2010 and 2014, 7.2 percent of rural hospitals in nine states closed their obstetrics units, according to one analysis.
“Like rural hospitals across our nation, our success depends on having both the financial resources and the patient volumes required to ensure delivery of high-quality care and patient outcomes,” Boula said in the statement. “We take this responsibility seriously and are doing all we can to focus our resources on the services most needed and utilized by our community” while ensuring the hospital’s sustainability.
Medicaid often pays for the majority of births at rural hospitals, at rates that total about half the amount that private insurance pays. That can make it difficult for hospitals to cover the costs of the units, such as paying staff and purchasing and maintaining equipment.
Gov. Paul LePage’s proposed cuts to Medicaid would further stress the Calais hospital and small, rural “critical access” hospitals like it, according to the Maine Hospital Association. Under his proposed two-year budget, Calais would face cuts totaling $500,000 in fiscal year 2018 and $800,000 per year starting the following year.
“There is simply no way for these hospitals, many of which are already operating in the red, to absorb these cuts,” Jeff Austin, a lobbyist with the hospital association, said. “The Medicaid budget is in balance and cuts to hospitals are absolutely unnecessary and unfair.”
Calais Regional Hospital ended 2016 in the red, with $1.3 million in losses, according to its annual report.
The nurses’ union, however, asserted that the Calais hospital is wasting precious dollars by making annual payments to its management company, Quorum Health Resources.
“This hospital spends over $400,000 on an outside management company based in Tennessee that has a history of reducing services to communities in order to extract more money,” emergency department nurse Beth Ingersoll, chief steward of the Calais-area MSNA chapter, said in the union statement. “Resources should be spent right here, in Washington County on patients that need these services.”
The union announced a candlelight vigil to save the obstetrics unit will be held at 8 p.m. Friday, June 2, at Triangle Park in Calais.
The hospital said it will notify patients and referring physicians of the closure and work to ensure a smooth transition. Current patients who have questions about their care are encouraged to contact their OB physician.
“We know there are some strong emotional ties to the CRH OB Department,” Ericka Marshall, VP of clinical operations, said in the statement. “Several generations of families, including my own, have had their babies born here. While this is a difficult decision, we remain proud of the excellent patient care and service that our OB department physician, nurses and staff have provided to many families over the years.”