Dear Readers,

Was that big bang you heard last week someone blasting out a granite ledge, or was it a collective gasp from top executives at Maine Health/LincolnHealth? I am not sure, but it came on the same day Mary Mayhew, the state health commissioner granted them permission to merge St. Andrews Hospital with Miles Memorial under the umbrella of Lincoln Health.

But her ruling had strings attached. Big ones.

The commissioner ordered LCH to expand its urgent care services at the former St. Andrews Hospital to provide care 24 hours a day, seven days a week. It is now open for just 12 hours, from 8 a.m. to 8 p.m.

Her order echoed the wishes of many in our communities who say that the closure of St. Andrews’ emergency department and skilled care beds puts our community at risk.

“I have determined that the ordinary economic development of healthcare for the Boothbay region would be adversely affected, and this specific application would have to be denied if the applicant who provided acute emergency care was not required to maintain an appropriate urgent care presence,” Mayhew said.

And if LincolnHealth officials did not go along with the terms of her order, she threatened to drop the hammer on them.

“Any such variances may result in either the disallowance of related expenses, financial penalties or the immediate revocation of the Certificate of Need (the state hospital license),” she said.

Needless to say, the order surprised LCH officials.

Jane Good, the Southport hairdresser who for the last two years has been a spark plug in the community effort to block the hospital's merger plan, was thrilled. So were a lot of our friends and neighbors.

Good said she received about 25 phone calls and 55 emails congratulating her and leaders of the foundation. Hundreds of visitors to the Boothbay Register website have clicked on Sue Mello’s story about Mayhew's order. Portland Press Herald also covered the story, and it was covered on TV news and radio.

While she was pleased, Good cautioned that this was just one step in a long and complex process. She expects LincolnHealth to appeal, and suggested her group is considering an appeal, too.

Mayhew's order gives LincolnHealth 90 days to expand its urgent care center hours. That would put the opening date into the last week of August. Good notes that our summer tourist season, the time when we have the greatest need for their services, will be nearly over before the clinic hours are expanded.

Inside the LincolnHealth corporate offices, I imagine administrators and their bosses from Maine Health huddled behind closed doors with lawyers as accountants ran the numbers for the newly ordered services.

Meanwhile, up the coast, two doctors at another Maine Health hospital, Pen Bay Medical Center, went public last week criticizing their corporate management. They claimed non-medical administrators told doctors they may not spend more than 15 minutes during most primary care evaluations. And they say the mother ship — Maine Health — is draining their limited hospital fiscal resources.

The whole local healthcare situation is getting to be very, very interesting. Stay tuned.