A United Ambulance Service crew loads an empty stretcher into an ambulance Friday morning after delivering a patient to Central Maine Medical Center in Lewiston. Russ Dillingham/Sun Journal

LEWISTON – People should not delay seeking emergency care at Central Maine Medical Center, the chief medical officer for the hospital’s parent company said Thursday, even as the hospital works through what its CEO called “acute staffing shortages.”

“If you come through our doors, we will care for you and determine with you the best course of action to be able to bring you quality care,” Dr. John Alexander, chief medical officer for Central Maine Healthcare, said in a statement Thursday evening.

“While Central Maine Medical Center is temporarily suspending admissions of pediatric and trauma patients at this time, we continue to treat these patients at the CMMC Emergency Department. We urge you to not delay emergency care.”

Alexander said patients will be evaluated and stabilized and, if necessary, will be transferred to another hospital or facility for inpatient treatment. CMH’s pediatric primary care offices remain open and operational.

On Tuesday, CMH confirmed it had stopped admitting pediatric and trauma patients to the hospital. Pediatric admissions were halted “until further notice” and trauma admissions would be reevaluated every 24 hours.

“The highest priority of CMMC is providing safe care for our communities. In order to meet that commitment, CMMC is curtailing these services in response to unprecedented health care workforce shortages,” CMH said in a statement.

On Monday, cardiac admissions were also suspended at the hospital, but that restriction was lifted Tuesday.

CMMC will also close its neonatal intensive care unit on Oct. 25, meaning babies under 35 weeks of gestation will need to be transferred to another hospital that can provide their care. The unit’s closure is the result of “resignations of key staff that exacerbated an already fragile health care workforce,” officials said.

Alexander said there was “no single cause that led to these temporary actions.” He said the local decisions were made as health care systems across the state and country deal with the compounding effects of the pandemic on an already strained workforce.

“A gap in specialized, qualified staff at any time during a 24-hour day requires us to evaluate our ability to make a particular service available,” he said.

Emergency medical services will always take critical patients to the nearest hospital, or the hospital that a patient requests, Joe Lahood, operations manager for United Ambulance Service in Lewiston-Auburn, said.

But if CMMC has suspended pediatric admissions, as an example, a critical patient brought to CMMC would be stabilized and CMMC would call other hospitals to find an available bed, after which providers there would call an ambulance to transfer the patient to the other hospital.

That might mean more time before a patient can be admitted to a hospital for inpatient care.

A “diversion” is slightly different from a suspension of admissions, Lahood said. “Going on diversion” is a term typically used by hospitals to communicate with EMS that their emergency departments are overcrowded, or that the provider-to-patient ratio has reached “an unsafe capacity,” he said.

“That’s why they want to try to keep patients that are not critical away from their ERs, so they can get their feet under them and get caught up, you know, and get things under control,” he said.

Those patients might go to St. Mary’s Regional Medical Center, Lewiston’s other hospital, instead. St. Mary’s said earlier this week that it was able to accept patients from CMMC.

“I don’t think people should be concerned that they won’t get care,” spokesperson Steve Costello said Thursday. “However, depending on the circumstances, they may be in a different place than they’re normally used to, (like) if they have a situation that requires them to go to Portland. That may happen. And I think that’s probably true in many places around the state right now dealing with patients.”

Diversions are not uncommon, and a hospital’s capacity changes constantly, Lahood said. A hospital might update EMS dispatch every 10 minutes or every few hours, depending on what’s happening in the emergency department.

Though diversions or suspension of admissions is not entirely unusual for a hospital, it is significant when considering that CMMC is one of only three regional trauma centers in the state.

That means CMMC is usually on the receiving end of patient transfers from smaller hospitals. CMMC is accredited as a Level II trauma center by the American Trauma Society. Northern Light Eastern Maine Medical Center in Bangor is also Level II; Maine Medical Center in Portland is Level I, the highest accreditation rating.

If CMMC does not have the capacity to admit trauma patients that require care, after they were stabilized and deemed medically sound to be moved, those patients would be transferred to one of the two other trauma hospitals in Maine, or could be taken to a hospital out of state.

According to Maine EMS, CMMC is the regional trauma center for St. Mary’s, Franklin Memorial Hospital in Farmington, Stephens Memorial Hospital in Norway and Rumford Hospital, which is part of CMH. Bridgton Hospital in Cumberland County, which is also a part of CMH, sometimes sends to CMMC.

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