Northern Light Inland Hospital at 200 Kennedy Memorial Drive in Waterville will close in June. Northern Light Health officials announced in March the hospital and its affiliated clinics will stop services May 27. Rich Abrahamson/Morning Sentinel

WATERVILLE — Details about the impending closure of Northern Light Inland Hospital became clearer Tuesday as the City Council and a former mayor sought answers from two Inland officials.

They wanted to know the status of Inland employees and whether they have found other jobs, if patients will be able to access care after Inland closes and where they will be taken in emergencies.

Inland President Randy Clark, who also is president of Sebasticook Valley Hospital in Pittsfield and Lakewood nursing care facility adjacent to Inland on Kennedy Memorial Drive; and Marie Vienneau, senior vice president and regional president for Northern Light Health who oversees Inland, presented what they said were the most up-to-date details.

Inland had 309 full-time equivalent employees and about 390 full-, part-time and per diem workers, Vienneau said. About 150 have either secured jobs in the Northern Light Health system or are in the application process. A job fair last week at Inland drew 15 other regional employers who met with more than 100 employees.

“There’s demand for these employees,” she said. “We feel very strongly that the market will absorb them because they are clinicians, nurses, (patient service representatives), people that work in health care. And as you know, there are shortages most everywhere so we’re feeling very positive about how the employees will end up.”

The hospital is scheduled to close June 11, but the last clinical day is May 27. Lakewood nursing home will remain open, as will Northern Light locations in Madison and Unity, Clark said. Officials have been working with MaineGeneral, Redington-Fairview General Hospital in Skowhegan and Northern Light to figure out where primary care providers will go.

Of 19 primary care providers associated with Inland, 15 are staying within 23 miles of where they are now, Clark said. Three have left Northern Light and one hasn’t yet made a decision. So far, five primary care providers will transition to MaineGeneral locations in Oakland and Augusta.

As the date for closing nears, more employees are leaving, which is challenging for keeping Inland open, he said.

The emergency department will be closed for ambulance calls on May 23, he said. The department itself will close May 27 and an ambulance will remain there 48 hours after closure.

The walk-in care site on Kennedy Memorial Drive will remain open and will be run by Sebasticook Valley Hospital, Vienneau said.

MaineGeneral officials have told Northern Light that the emergency department at Thayer Center for Health in Waterville is large enough to accommodate the 10,000 visits Inland received annually, according to Clark and Vienneau, who said MaineGeneral officials told them Thayer was built to receive 30,000 annually and have been seeing 20,000.

Councilor Brandon Gilley, D-Ward 1, asked what will happen with the Purdue Global School of Nursing program located at Inland. Clark said Inland owns the building and Purdue really wants to be tied a hospital so they have been talking to other Northern Light locations.

“Really, the decision is theirs but more than likely, I would say that it may not be there after the fall,” he said.

Councilor Thomas Klepach, D-Ward 3, said there have been a significant number of outpatient services on site at Inland.

“Which of those services are going to be the most displaced? Do you have a sense of that?” Klepach asked.

MaineGeneral officials have said they can take on most of the volume of patients needing mammogram, rehabilitation and other such services, and some specialists are still trying to figure out where they are going,  Clark said. But, Vienneau said, finding specialists such as neurologists and cardiologists is more challenging, and that is the case across Maine.

Northern Light officials announced March 13 that high operational costs, low reimbursement rates and ongoing struggles with staff recruitment and retention contributed to the decision to close Inland, located at 200 Kennedy Memorial Drive.

Waterville officials Tuesday wanted to know more.

“What happened here?”Klepach asked. “Is this a contraction to assure the continuity in solvency of the network in general? I know it’s a loaded question, right, but I want to understand. Northern Light is a big part of the broader landscape of care which is infamously fraught in rural communities in rural states. I want to understand  the loss that Waterville is sustaining here. Is this toward the greater solvency and strength of the regional care in Maine or is it a reallocation of resources?”

Vienneau, who trained as a nurse, said it is essentially the result of 10 years of sustained financial losses.

“We don’t have the market share,” she said. “Inland is only taking care of about 13% of the Waterville population. The patients had already gone to MaineGeneral, essentially, to other providers. They do not seek their care, for the most part, at Inland Hospital.

“We sustained it for many years as a system to the tune of losing over $56 million. By the time it’s done, we will have invested $70 million of lost dollars into this hospital to try to keep it going as a system.”

Clark said Inland had the capacity to serve 26 inpatients but it averaged 15, so inpatient care is not really a money maker. Part of the decision to close included the fact that the hospital is aging and in need of heating, ventilation and air conditioning, boiler and electrical improvements and  there is no money to invest in that, he said. The hospital sits on about 30 acres and includes several buildings.

About $30 million would be needed to make such improvements, to maintain it as a hospital, he said.

Former Waterville Mayor Karen Heck wanted to know what amount of reimbursement is from Medicaid. Clark said 65% of its business comes from government payers, including Medicaid and Medicare, with Medicaid being about 20%. Heck then referred to current discussions at the state level now about whether to increase Medicaid reimbursement or pay for Medicaid.

“If there’s not an increase in the Medicaid reimbursement, for any hospital, that means higher costs for everybody who’s got insurance, right?” she said, asking how else the hospital generates revenue.

Vienneau said the commercial payers restrict hospitals from operating the way they used to.

“We can’t cost-shift Medicare and Medicaid losses to commercial insurers in the way that we did 15 years ago. So, the reimbursement mechanisms have changed and the commercial insurers are much more savvy and they even make it difficult. Medicare advantage plans make it very difficult for us to get paid, even though that’s a commercial insurance.”

Heck noted that hospitals have to make up for that loss of money, and all hospitals face the same issue.

“I just want people to understand that when everybody says, ‘Oh, cut Medicaid, cut Medicare, cut these things,’ that the rest of us are going to pay, in one way or the other,” Heck said. “Either the hospitals are going to close, and they have been in rural areas, or cut services.”

“You’re exactly right,” Vienneau said.