The Maine Department of Health and Human Services has approved the merger of two hospitals in the midcoast, on the condition that they open a round-the-clock urgent care center on the Boothbay peninsula.

An official with Lincoln County Healthcare, which sought the state approval, called the urgent-care requirement a surprise and said the health care provider is considering how to respond.

But a member of a task force that formed last year because of concerns about possible changes by Lincoln County Healthcare said she was thrilled with Tuesday’s decision by the DHHS.

“We feel like we’ve been heard by the powers that be in Augusta,” said Patricia Seybold, a Boothbay resident.

DHHS Commissioner Mary Mayhew authorized a certificate of need that allows Lincoln County Healthcare to acquire full control of Miles Memorial Hospital in Damariscotta, St. Andrews Hospital in Boothbay Harbor and Cove’s Edge, a nursing home in Damariscotta.

In a letter to Lincoln County Healthcare President James Donovan, Mayhew said development of health care in the region would be “adversely affected” without an “appropriate urgent care presence.”

The merger, she wrote, is contingent on the opening of a 24-hour urgent care center in Boothbay within three months. The center must remain in operation for at least three years unless Lincoln County Healthcare can prove there is not enough demand to justify the cost. If that happens, the center could close in as little as 18 months.

Lincoln County Healthcare was formed in 2007 as a way to merge the two hospitals under one management team with one board of trustees.

The company, which is part of MaineHealth, the state’s largest health care organization, closed the emergency room and eliminated other services at St. Andrews in October because of financial concerns and a low volume of patients. Emergency room visits had decreased from about 4,700 in 2007 to about 3,700 in 2012. The cutbacks led to the elimination of about 50 jobs.

St. Andrews converted its emergency room to an urgent care center, but that facility is open only 12 hours each day and is not equipped to handle critical care patients.

An urgent care center is not authorized to treat patients who arrive by ambulance. Those patients now go to Miles in Damariscotta, which is a half-hour-drive away from some parts of the peninsula. The hospital is being reduced from 38 beds to 25.

Donovan, Lincoln County Healthcare’s president, was not available for comment Thursday because of a family matter, said Scott Shott, vice president of development, marketing and communications. Shott released a statement on the merger.

“While we have received and read the commissioner’s letter granting conditional approval of the certificate of need, we are surprised by the condition requiring Lincoln County Healthcare to provide urgent care services at LincolnHealth – St. Andrews Campus 24 hours a day, 7 days a week,” it read. “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.”

It was not clear Thursday how much it would cost Lincoln County Healthcare to operate an urgent care center around the clock or whether the state would provide any funding.

“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’s statement concluded.

Some residents of the Boothbay peninsula who opposed the merger and the closure of the emergency room organized a task force, called the Health and Wellness Foundation, to fight the decision.

Their initial concerns were over long travel times for patients in Boothbay who might have to drive to Damariscotta for certain care. The task force’s concerns have since broadened to include how Lincoln County Healthcare provides care to the region and whether it meets residents’ needs.

Seybold said she fully expects that the provision in the merger approval to keep a 24-hour urgent care center will end in 18 months.

“But we still think that gives us in the community time to figure out what the next step should be,” she said. “We think it’s important that we take control of our health care and not rely so much on LincolnHealth.”

Eric Russell can be contacted at 791-6344 or at:

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Twitter: @PPHEricRussell