While Lincoln County Healthcare has been working to adapt to changes in the healthcare environment, residents here have been struggling to understand what is happening, and when, why and how it's happening. Here’s an update on changes to the board of trustees, progress on keeping patient beds on the peninsula and consolidation of billing staff.

Board of trustees

LCH announced its newest board member last week: Dr. Jack Fulmer replaces Leslie Bird, former Bigelow Laboratory financial officer who left Boothbay Harbor in April.

How does someone become a board member? LCH Board Vice Chairman Jeff Curtis said LCH’s board operates like other area nonprofit boards. “We look at the expertise we have and see if there are needs that aren’t being met,” Curtis said.

Nominees frequently come from the board’s finance, quality assurance, senior living and fundraising committees, which include non-board members. Curtis said this is how Fulmer was recognized.

“We look for community members with integrity, common sense and who are able to digest all the material,” Curtis said. “Some people find their interest in healthcare doesn’t stand up to the demand.”

Curtis said the process begins with nomination and approval at the local level; ultimately board nominees must be approved by MaineHealth. “It’s a bottom up process,” Curtis said.

LCH CEO Jim Donovan said the board selection process has not changed over the years, but there has been a shift in focus to include more physicians in recent years.

On the original LCH Board, three of the 20 members, Steven Cook, Daniel Friedland and Mark Fourre, were physicians. With the addition of Fulmer, the LCH board now has nine physicians among its 21 members.

Board Chairman Peter Mundy of Boothbay Harbor and Norman Hochgraf of Bristol will both leave the board at the end of September. Curtis said the board is considering replacements but has also discussed whether the current board may be too large.

“We’re not feeling great pressure to fill the two positions; we’re being deliberative,” Curtis said.

Swing beds

Changes at St. Andrews Hospital are expected to result in the end of hospital licensed patient beds on the peninsula.

Since last fall, LCH has sought to either keep the beds at their current location under a nursing facility license or to meet the need for recuperating patients and palliative care at St. Andrews Village.

St. Andrews Village has 26 independent cottages, as well as 29 apartments dually licensed for independent and assisted living. Executive Director Wendy Roberts said the Village offers three different levels of assisted living care. Eleven memory loss rooms are also available at the Village’s Safe Haven.

St. Andrews Village’s Gregory Wing is a 30 bed nursing care facility. Six of those 30 beds are dually licensed for skilled or long-term care. “We have not been using those beds for short-term care but we could,” Roberts said. “We could offer the same services in those beds as the swing beds in the hospital.”

With three months left before the October 1 hospital changes take place, LCH is still working on its plan to provide skilled nursing beds for recuperating peninsula residents, Donovan said.

The swing unit at St. Andrews Hospital has had a daily census on average of 10 patients, he said, with about five from the Boothbay peninsula.

“Our focus is providing for those patients,” Donovan said, “We think we can find a workable solution that is short of a certificate of need process and capital project.”

Donovan said while he does not think there will be a need for more hospital beds in Lincoln County in the future, given the demographics, the county will need more senior services.

“Somewhere down the line, we are going to need to figure out how to expand capacity,” Donovan said.

Billing department move

LCH finance department employees who had been anticipating possible relocation have been given a temporary reprieve.

In July 2012, LCH announced that the billing and collections portions of its finance department would be relocated to a new centralized MaineHealth accounting office to be located in Rockland. Donovan said that difficulties with implementation of the shared electronic medical record system, which includes billing information, puts those plans on hold temporarily.

LCH was scheduled to go live with the new MaineHealth system-wide electronic medical records system on July 1, 2013 but problems with implementation have pushed the entire project back considerably, Donovan said. He said LCH is now scheduled to join the new system in 2016.

LCH’s financial share of the new electronic medical records project totals $5.5 million, half of which has been already paid. Donovan said he expects the $5.5 million to be reimbursed under the American Recovery and Reinvestment Act but any further expenses for the project will not be covered by the federal government.

Sue Mello can be reached at 207-844-4629 or suemello@boothbayregister.com.Sue Mello can be reached at 207-844-4629 or suemello@boothbayregister.com.