August 4, 2013

Letters to the editor: Looming hospital closure deplored

St. Andrews Hospital's impending closure, outlined July 28 ("Boothbay region 'full of fear' as hospital closing looms"), deserves comment in this state with many small hospitals.

St. Andrews is a special kind of hospital, called a "critical access hospital," one of 1,340 such small rural hospitals in the U.S. These hospitals were intended to meet the needs of places like the Boothbay peninsula, remote from other hospitals.

They get some extra payments from Medicare. They get more than 70 percent of their revenue from their outpatient clinics. They average fewer than four acutely ill patients in the hospital at a time. Practically all lose money on their emergency rooms.

If a hospital and a community don't support each other, the hospital will disappear. If management separates the critical access hospital from the outpatient clinic operation, it's as good as closed. Emergency rooms are like fire departments -- they don't make money. Closing ambulatory surgery suggests a decision to close the place and move that revenue stream elsewhere.

The position that emergency rooms should close that can't maintain at least two physicians is particularly troublesome.

All of the 1,340 critical access hospitals have emergency rooms. That is a major reason they exist. Very few have multiple doctors, nor do many other rural hospitals at $300,000 per doctor per year per shift, with benefits.

Ideal, perhaps. Weigh that against the loss of at least 2,000 single-doctor ERs across the country. It's not gonna happen.

The fact that Miles Memorial Hospital in Damariscotta is concurrently dropping its bed complement to 25 suggests it will apply to "inherit" St. Andrews' critical access designation and beneficial payment status. Miles wouldn't qualify on its own, being too close to other hospitals in Bath.

Bottom line: Boothbay, use it or lose it.

Wayne Myers, M.D.


St. Andrews Hospital does not lose money.

"St. Andrews actually turned a $182,000 profit last fiscal year and $874,000 in fiscal year 2011 but has an overall loss of about $2 million over the past 13 years."

So said the Portland Press Herald/Maine Sunday Telegram, wrongly, in its July 28 front-page story.

Mark Twain said, "It's not what you don't know that hurts you, it's what you know for sure that just ain't so." Of the three numbers quoted above, two of them just ain't so. The only correct one is that St. Andrews reported a bottom-line profit in 2011 of $874,000.

Why does the story cite a long-term loss of $2 million when St. Andrews reported not a loss but a bottom-line profit of more than $5 million for the period?

Why does it understate last year's profit at $182.000?

And why did the annual report published for St. Andrews last year show a profit of about half the $874,000 actually posted?

MaineHealth and Lincoln County Healthcare want you to believe that St. Andrews "loses money," so they misleadingly present other lines as the true bottom line. Two of these misrepresentations are included in this story, as quoted above. In fact, St. Andrews does not lose money. Its own audited financial reports show that it is profitable.

Altogether too many people have been hoodwinked into thinking St. Andrews "loses money" when it does not.

The Press Herald should print a prominent retraction to correct this gross misrepresentation of the facts.

Tom Hagan


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