FORT KENT, Maine — Northern Maine Medical Center, the only hospital in the St. John Valley region, has applied for a “critical access” designation in order to address its financial problems and will eliminate a children’s behavioral health unit as a result.
The critical access designation is a federal program administered by the Centers for Medicare and Medicaid Services that helps rural health care facilities stay viable. Currently, NMMC is classified as an acute care hospital, according to its website. Critical access hospitals reduce their costs by offering fewer services than acute care facilities.
The change will help the hospital stay afloat amid financial challenges, but the facility will lose its seven-bed child/adolescent inpatient behavioral health unit, NMMC officials said.
CMS limits the number of inpatient beds for hospitals applying to become a critical access facility, but the hospital chooses which beds to reduce. In this case, NMMC dropped the child psychiatric unit’s beds.
The move comes amid financial hardships that have hit hospitals in Aroostook County and beyond, with Northern Light A.R. Gould eliminating several positions in its Presque Isle hospital last month and closing its Mars Hill Health Center in 2022. Farther south, Northern Light Health System has been cutting services. NMMC, which is not part of the Northern Light Health System, also closed its obstetrics unit last year.
Hospital CEO Jeff Zewe and Chief Financial Officer Aaron Teachout updated the Fort Kent Town Council on NMMC’s status during a Sept. 23 town council meeting.
“We went to the state multiple times to see if we could keep the child unit, and just found a couple weeks ago that we didn’t get approval,” Zewe said.
The move to drop the child psych unit affects patients beyond the St. John Valley. Only 12 percent of the child unit’s admissions came from the hospital’s service area, whereas the other admissions were from outside Aroostook County. Zewe, during the meeting, said this amounts to roughly 15 to 20 local admissions per year and 130 from downstate.
Hospital officials said they believe this will not result in a significant impact on employment, “as jobs are available throughout the NMMC system,” according to a press release issued by the facility earlier this month.
The hospital’s behavioral health team – which also covers the adult unit – consists of four individuals, according to the NMMC website. The hospital’s medical staff totals 55 members, according to the website.
“It loses us money,” Zewe said of the child psych unit, “but we looked at it as providing a service, a regional resource. So it’s unfortunate, but we have to close it.”
The hospital’s nine-bed adult behavioral health unit will stay open.
Zewe said the hospital has received state approval for the critical access designation, but that they are still awaiting federal approval. Hospitals with the CAH designation are reimbursed by CMS based on their Medicare and Medicaid population. Zewe said the designation will bring the hospital about $3 million more annually.
Out of the state’s 36 hospitals, 17 are designated as critical access hospitals.
Teachout said the hospital’s financial outlook is looking much better than before. He said they had an outside firm come in to look at losses amid the COVID pandemic, and that they predicted a $13 million loss by 2025. Now, he said current projections show that they will likely break even by next year.
“Now we can start building the other way and get ourselves out of this,” he said.
Zewe said the hospital is opening outpatient rehabilitation services again, after divesting from these services over a decade ago. He said this lines up well with the recent hiring of orthopedic physician Dr. Joshua Mayich.
“We think he’s going to be somebody that’s going to come in and do a lot of really good work,” Zewe said.
He said Mayich does ankle, foot, trauma, knees, and hip work. He said they are also having a doctor from Boston come in who can work on shoulders.
“That will be a big deal for the community,” he said. “We want to look at it as not just orthopedics and rehab, but it’s more of a service line. They go hand in hand.”
He said the hospital also began collaborating with St. John Valley Pharmacy in Fort Kent, which will better address community needs. By working together instead of competing, he said they will better be able to meet the demand for resources in the area.
Zewe, who came on board in 2022, said he is feeling more optimistic than ever about the future of the Fort Kent hospital.
“This is the most comfortable I’ve felt since I’ve been here,” he said. “We’re heading in the right direction.”
This story was updated to clarify that NMMC chose to eliminate the child psychiatric unit beds and was not required to do so.
