Roger Santerre of Clinton holds a sign and waves as a motorist honks March 24 at Northern Light Inland Hospital off Kennedy Memorial Drive in Waterville. Since the hospital announced it was closing, Santerre, a retired registered nurse, and others have held signs in front of the building in support of the hospital. Rich Abrahamson/Morning Sentinel

WATERVILLE — Northern Light Health officials announced Thursday that most patients who receive primary care at its Inland Hospital and affiliated locations will be able to stay with their current primary care providers once Inland Hospital closes in June.

At the same time, MaineGeneral Health leaders announced changes to the Augusta hospital and other health care sites to help patients who will be displaced.

“We know these changes are difficult,” MaineGeneral President and CEO Nathan Howell said. “We do not take this lightly, which is why we are transparent about the challenges we face and the need to address them now. We remain committed to offering sustainable, high-quality services that are most needed locally.”

Nathan Howell, MaineGeneral Health president and chief executive officer, announced changes to its facilities.  Photo courtesy of Rene Roy

Plans include converting the inpatient physical rehabilitation unit at MaineGeneral Medical Center in Augusta into a medical-surgical unit May 8 to increase capacity by 12 beds to 134 and reorganizing rehab services; freezing spending across departments through June 30 to save about $4.2 million; closing the gift shop at the Augusta hospital and reducing cafeteria offerings at the hospital and the adjacent Harold Alfond Center for Cancer Care; and moving MaineGeneral Augusta rheumatology and neurology offices from 15 Enterprise Drive to 442 Civic Center Drive, Howell said in a statement issued Thursday.

The hospital has 198 beds, which will not change with the new med-surg beds, as the rehab beds will be removed. Hospital beds now are filled at 98% capacity, officials say. Rehabilitation services will be reorganized to redeploy employees, and those patients’ needs will be met with other existing services at Gray Birch and Glenridge, MaineGeneral’s long-term care facilities in Augusta.

Starting June 2, services for Workplace Health, located at Thayer Center for Health in Waterville, will be reduced, but full service will be available in Augusta. Anticoagulation and diabetes and nutrition clinics will operate four days a week instead of five.

The changes were announced Thursday to all MaineGeneral staff, said Joy McKenna, MaineGeneral’s director of marketing and communications.

In other changes, 148 positions will see reductions, Howell said. Of that number, 54 are unfilled or open positions and will be closed, 60 employees have been offered redeployment, 14 will have reduced hours and 20 filled positions will be cut.

The immediate goal is to identify $30 million in savings, and every effort has been made to minimize the impact to employees, patients and the community, Howell said.

Howell said Thursday MaineGeneral has been working with Northern Light leadership to develop a plan to help Northern Light provide care for its patients.

“These plans are complicated by the challenging financial climate facing health care statewide and nationally,” he said. “Access to primary care services were already strained across the state. The process to address the primary care needs of thousands of Inland patients takes time. We have been collecting information from patients who want to transition to our practices, and expect to be able to connect with them in the next few weeks. During this unsettling time, we appreciate continued patience from those who have contacted us.”

Howell said while a lot of focus is understandably on primary care needs, MaineGeneral officials know other areas of health care must be addressed in light of the impending Inland closure, including regional inpatient bed capacity. At the Augusta hospital, the bed capacity is limited.

“Underlying all these changes, it’s important to remind our community that health care finances are severely strained,” Howell said. “We are taking steps to mitigate this impact, including making the tough decisions to implement a reduction in force and to change a number of programs and services. This is necessary to ensure that we are here to serve our patients and contribute to our communities now and into the future.”

Howell said these are anxious, uncertain times for many people.

“We’re doing our best to meet the needs of our community, because ‘We’re with you’ isn’t just something we say, it is something we work hard to deliver every day,” he said.

Last month, MaineGeneral announced it would address financial challenges to ensure sustainability of services needed in Kennebec Valley now and into the future, Howell said. The challenges include reimbursements that don’t cover the cost of care, excessive insurance denials and increased costs of doing business.

“Most recently, the withholding of MaineCare funding by the state has an impact of approximately $600,000 a week. We cannot continue with ‘business as usual.’ There are no easy, painless cuts left to make, or easy revenue streams to tap into. While we continue to look to create more revenue, we must make reductions in discretionary spending, labor and benefits and programming,” he said

Inland patients on edge

Patients at Inland and affiliated offices expressed worry this week as they continue to seek primary care offices that will take them after the hospital closes, and wonder where they will go if they need to be hospitalized.

Marlene Lachance, 90, of Winslow said she loves her doctor of many years, and she doesn’t know what she will do when he leaves. She hopes he announces he will go to another office and can continue to keep her as a patient.

A retired medical secretary, Lachance said she drives, but only in the Waterville and Winslow area, so if she has to travel any farther for care, someone will have to take her. She not only sees her doctor at Inland, but also gets her blood work and other services there, she said.

“I don’t know why Inland wanted to close,” she said. “I know other people that feel the same way. It’s very scary to know what’s ahead of you. When you’re elderly, it’s not easy.”

Lachance said she can’t visit friends who have been hospitalized in Augusta unless she gets a ride because she doesn’t drive that far. With Inland gone, she fears emergency room waiting times also will be much longer.

“It’s going to be very, very difficult, especially for the older people,” she said. “It’s too bad. It’s awful. Every time I go by Inland, it hurts.”

Dwayne Rioux, 71, also of Winslow, has similar concerns. When he went to an appointment at his doctor’s office Thursday he learned  the doctor would move to Northern Light’s Unity office so he could see him there, if he wishes. It would be a 25- to 30-mile drive, but Rioux said he is OK with that.

Rioux, a retired writer for the Morning Sentinel, received care through Inland for about 30 years, he said. He underwent heart surgery in 2010 and again in January. He needs a new cardiologist but has not yet found one. In the meantime, his primary care doctor can regulate his heart medications. That had been one of Rioux’s biggest worries because his heart medications are critical to his health.

“Everybody’s in the same boat,” he said. “It’s going to be a catastrophe to this area.”

Ken Quirion said he’s been waiting for word from Northern Light about where to seek health care after Inland closes. The Winslow resident received a letter from Northern Light explaining what is happening and is waiting for a second letter that is supposed to contain more information.

Quirion, who was treated for cancer in the past and has kidney issues, said his longtime primary care doctor has a large patient load. He has spoken to some of those patients and they haven’t heard anything either. They hope the doctor will continue in practice somewhere close by.

“I don’t know what’s going to happen,” Quirion said. “It’s awful. What are they going to do?”

A retired state fire investigator who formerly volunteered for MaineGeneral and Hospice Volunteers of Waterville Area, and who now volunteers on his own, Quirion is very familiar with Waterville and Augusta health care facilities as he drives patients to and from them all the time. He said he knows of several doctors who have retired or are going to retire, which will exacerbate the problem.

“This is a big deal — people don’t realize it,” he said.

Northern Light, Redington-Fairview respond

Randy Clark, president of Northern Light Inland and Sebasticook Valley hospitals and senior vice president for Northern Light Health, said officials have been working hard to determine next steps for patients.

A large part of that is knowing the next steps for providers, and that information is being shared with patients as plans are confirmed to try to avoid confusion or any more frustration, Clark said Thursday .

“We understand that not knowing is frustrating, but that the wrong information shared prematurely will not make this better,” he said. “Many patient letters are in process or in the mail at this time.”

Clark said many current Inland providers will continue seeing patients, but officials also want to be clear they don’t yet have all the answers for providers and patients. If patients have not received follow-up communications about their providers, they will receive more information soon.

Most current primary care patients will be able to stay with their primary care providers at the same practice or at a new practice in the region, and officials will update Northern Light’s website with details this week, he said.

“Again, we want to stress that we intend for all of our patients to receive personal outreach in the mail with updated information about their provider/practice as information is confirmed. For patients whose providers confirm they will not be able to retain their current patient panel, we will continue to connect these patients with resources to select a new provider – including providers at Northern Light Health who have availability. At this time, just three primary care providers have confirmed that they will not be able to retain all of their patients.”

Northern Light Primary Care in Unity will remain open, Clark said. The practice will move under the operations of Northern Light Sebasticook Valley Hospital and all providers there will continue seeing their patients. Two other primary care providers will join the practice location, and their patients will be able to see them there.

Any patient of a Northern Light Health provider who is moving to another Northern Light location will be able to seamlessly move their care and continue to see this provider at their new practice, Clark said.

“We have confirmed that three primary care providers will be joining MaineGeneral Health primary care practices, and these providers will be able to retain their patients – meaning these patients will be able to follow these providers to their new external practices.”

Northern Light Primary Care, Madison, will remain open under new ownership. The details of that transition are still being finalized and cannot be shared at this time, but patients of providers at this practice will also be able to continue their care with those providers. Dr. Paul Bassett, who currently splits time between Northern Light Inland Hospital and Northern Light Eastern Maine Medical Center, will continue to see his current Waterville patients at his Bangor practice.

Rheumatologist Elinor Mody will be seeing patients at Northern Light Sebasticook Valley Hospital and any current patients will be able to continue their care with her at that location.

Buffy Higgins, director of operations for Redington-Fairview General Hospital in Skowhegan, said that hospital is working to try to help provide care for those who need it.

“Our adult medicine primary care practices are experiencing a significant increase in call volumes from patients seeking new primary care providers,” Higgins said. “In response to the growing demand, each practice is currently assessing their capacity to accept new patients on a case-by-case basis, depending on provider availability.”