Celia Geel of Calais is expecting her second child. She and her husband will drive two hours to Bangor when the baby is due, but worry about paying for a hotel room if the baby is late. Staff photo by Brianna Soukup

CALAIS — The decision to end obstetrics services at Calais Regional Hospital is continuing to cause controversy in this Down East border town of 3,000 along the St. Croix River.

Hospital officials announced in May that they were being forced to close the obstetrics department this year to stave off deep financial problems that threaten the hospital’s survival. The final baby born in the obstetrics department was discharged from the hospital Tuesday.

“It has been painful for us to make these decisions,” Dee Dee Travis, the hospital’s vice president of community relations, said in an interview Wednesday. “It was sad, very hard, what we had to do.”

The Calais hospital is representative of the financial struggles of many rural hospitals, officials said. More than 80 of them have closed nationwide since 2010, according to the National Rural Health Association, leaving local residents farther away from hospital services.

Other hospitals, like the one in Calais, have ended money-losing services in efforts to have sufficient finances to keep operating.

Calais Regional Hospital is in Washington County, where births have been dwindling. They fell from more than 100 per year a decade ago to 64 in 2016 as the average age of the county population increased.

Now the closest facility that delivers babies in non-emergencies is Down East Community Hospital in Machias, about a 50-minute drive away, and some expectant moms will choose to drive two hours to a hospital in Bangor. Women who still require prenatal doctor visits will be able to keep their appointments through the end of September.

The loss of services has upset some Calais residents. A community candlelight vigil was held in June, and in July the City Council approved a resolution of “no confidence” in the hospital board of directors.

Calais residents participate in a community meeting Wednesday organized by the Coalition for Healthy Washington County to address the closure of Calais Regional Hospital’s obstetrics unit. Members of the hospital’s board of directors had chairs reserved for them, left, but did not attend. Staff photo by Brianna Soukup

Councilor Mike Sherrard said the criticism of a hospital that has been operating “in secret” is justified.

“They dropped a bombshell on us,” Sherrard said. ‘We would have done whatever we could have to help to keep OB services, but we weren’t given that option. We can’t help if we’re kept in the dark. This didn’t happen overnight.”

HALF A MILLION IN SAVINGS ANNUALLY

Rod Boula, the hospital’s CEO, said recruiting doctors and nurses is difficult in rural areas. Making it public too far in advance that officials were contemplating closing obstetrics would have “caused a mass exodus” of employees, he said.

Hospital officials said Wednesday that the facility has been operating in the red since 2010 and has zero reserves, and that without drastic measures the entire hospital could close.

“If we don’t make the necessary changes, we would last maybe a couple years at the most before we would close,” Boula said. “We’re still in a lot of danger.”

Rod Boula, CEO of Calais Regional Hospital, defends the board’s decision to make difficult but necessary changes, saying the facility “has to right itself. … We can’t be everything to everyone.” Staff photo by Brianna Soukup

Travis said the hospital is operating “payroll to payroll” and has no margin for error. Closing obstetrics will save about $500,000 per year.

The hospital has operated an average of $1.8 million per year in the red since 2010 and lost $1.2 million in 2016, according to documents provided by the hospital. It has lost a total of $12.8 million in seven years.

Through the first seven months of 2017, the hospital is operating $365,000 in the red, Boula said, but there are positions that need to be filled, so financial problems will persist next year even with the closing of obstetrics.

Research shows there has been an erosion in obstetrics services at rural hospitals over the past several years. In Maine, Penobscot Valley Hospital in Lincoln closed its obstetrics unit in 2014, and Blue Hill Memorial Hospital did the same in 2009.

Celia Geel, 30, of Calais, who is seven months pregnant with her second child, said she was upset to hear that she would not be able to deliver her baby in Calais in October. Instead, she and her husband will make the two-hour drive to Eastern Maine Medical Center in Bangor.

“I told him he better be watching some how-to YouTube videos,” she said.

Geel said she could try to stay in a Bangor hotel around her due date, but what if the baby doesn’t arrive for another week? She said she doesn’t have maternity leave and she can’t afford to take that much time off work. She’s trying to save up vacation time for after the baby is born.

“It’s causing a lot of unnecessary stress,” Geel said.

Some blame is being directed at Quorum Health Corp., a Tennessee-based for-profit company that operates the Calais hospital.

Todd Ricker, labor representative for the Maine chapter of National Nurses United, the nurses union, said the union will be delivering a letter to Quorum headquarters in Tennessee demanding that the company “leave our city now.”

“We do not need you in our community and we want you to go,” the letter says.

The union also hosted a public meeting Wednesday to discuss hospital services.

Boula said anger toward Quorom is misplaced because decisions are made locally by the hospital’s 15-person board of directors.

“This is a hospital that has to right itself,” Boula said. “We can’t be everything to everyone.”

A BIG LOSS FOR THE COMMUNITY

He said other service lines that he couldn’t publicly disclose may be closed or reduced in the coming years so the hospital can survive.

Caroline Coleman of Calais, who organized the June candlelight vigil and has three boys ages 7, 2 and 5 months, said access to health care for women in rural areas is already lacking, so to close obstetrics is a big loss to the community.

“As a mom, do I want to be five minutes away from the hospital, or 45 minutes away on a good day on a bad road,” Coleman said. She said some of the roads become especially dangerous and slow-going in the winter.

Travis said the Calais hospital is working with Down East Community Hospital and EMMC to have at least one obstetrician in Calais once per week so residents can attend pre-natal appointments locally.

Meanwhile, the Calais hospital is training emergency room nurses and doctors and the Emergency Department will deliver babies when the expectant mom can’t make it to the hospitals in Machias or Bangor.

But Alison Monaghan, an emergency room nurse, said it will be difficult for that department to become proficient at delivering babies when staffers will only be doing a few per year at most. And she said patients who need emergency cesarean sections will have to be transferred to EMMC because the Calais hospital will not be equipped to handle those deliveries.

Joe Lawlor can be contacted at 791-6376 or at:

[email protected]

Twitter: joelawlorph