Central Maine Medical Center temporarily stops pediatric and trauma admissions

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Oct. 13—LEWISTON — Central Maine Medical Center is suspending pediatric and trauma admissions due to "acute nursing staffing shortages in key areas," officials of the hospital's parent organization, Central Maine Healthcare, confirmed Tuesday afternoon.

Patients who arrive in the emergency department will be "screened, evaluated appropriately, stabilized and, if needed, transferred to another facility that can serve their needs," the statement said.

Pediatric admissions to the hospital are suspended "until further notice."

Trauma admissions will be reevaluated at least every 24 hours.

A notice was posted on CMMC's website Monday night that said it would suspend admissions for pediatric, trauma and cardiac patients. By Tuesday morning, the notice appeared to have been removed from the website.

"You may have seen that yesterday we also temporarily suspended STEMI (heart attack) admissions," the statement said. "At today's capacity review this suspension was lifted. We expected that the situation will remain fluid as we manage staffing to demand."

Later this month, CMMC will also close its neonatal intensive care unit.

"This action is being taken due to resignations of key staff that exacerbated an already fragile health care workforce," the statement said.

CMH spokeswoman Ann Kim said Tuesday afternoon that 84 staff members systemwide had either resigned or submitted their resignations in response to the vaccine requirement. About 230 staff have yet to get vaccinated or confirm their vaccination status.

All health care workers at designated facilities must be fully vaccinated against COVID-19, Gov. Janet Mills announced in August. The state has the authority to require vaccinations under a Department of Health and Human Services rule that was passed nearly two decades ago.

The deadline for the requirement was Oct. 1, but the state said it would not start enforcing it until Oct. 29.

CMH's president and CEO, Steve Littleson, told the Portland Press Herald on Tuesday that though he supports vaccinations, he is appealing to the governor's office for an alternative to vaccines, such as weekly testing.

"We have patients to care for, and if there's a practical solution other than reducing services and cutting bed capacity, I'm all for it," Littleson said.

Mills directed DHHS to continue working with CMMC and other hospitals to address workforce shortages.

"Now make no mistake: we will do everything within our power — and everything to protect public health — to ensure access to health services for Maine people if Central Maine Medical Center employees refuse to be vaccinated and leave their jobs," she said in a prepared statement.

CMMC is a 234-bed acute care teaching hospital and one of two certified Level II Trauma Centers in Maine, Eastern Maine Medical Center in Bangor being the other. Maine Medical Center in Lewiston is a Level I Trauma Center, the highest trauma certification a hospital can hold.

Lewiston's other hospital, St. Mary's Regional Medical Center, is accepting patients, spokesperson Steve Costello said Tuesday.

"COVID-19 continues to challenge all health care facilities in many ways. We are aware of the situation that Central Maine Medical Center is facing and have been in contact with them," Costello said in a prepared statement.

"At this time, St. Mary's Regional Medical Center has the capacity to receive additional patients and stands ready to assist in any way possible to provide the best care possible for our community."

Auburn Fire Department Chief Bob Chase said he was made aware last week that CMMC had put a diversion in place.

"We can still bring critical patients there if that's the best facility to get them stabilized," he said. "But again, the whole system is so strained (and) that's continuing to build on an already large patient backlog."

Chase said Auburn EMS had to bring three patients to Portland last week. They might bring three or four patients to a Portland hospital over the course of a typical year.

He said it's the "whole system, not just CMMC struggling with this trickle-down effect." When EMS crews have to travel farther to transport a patient or wait longer at an emergency department to transfer care to hospital providers because of a backlog of patients, it means more time that that crew is unable to respond to other emergencies.

Chase said Auburn Fire has received notices of diversion from other hospitals within the past couple of days, including St. Mary's in Lewiston and MaineMed in Portland.

"I think that's just the start of the problem that continues to grow as more and more hospitals continue to get overwhelmed," he said.

His department is looking to add more rescue crews but they are also short-staffed.

LifeFlight of Maine Executive Director Tom Judge said Tuesday that it's "business as usual." The emergency helicopter service is part of CMH and Northern Light Health, and is based out of the CMMC campus.

"There was nothing new or different with LifeFlight," Judge said. "And that can happen, hospitals can go on diversion and then go off diversion," depending on staffing or influx of patients.

"Beds are very, very dynamic across the state, he said. Everybody is struggling with bed availability," but that "there's no difference in care at Central Maine."

Judge said LifeFlight did not get a notice about diversion of services because they work from the same campus. Notification is more important for out-of-area emergency medical service agencies.

"The important thing is that people need to look at what Central Maine said" in the notice, he said. "A highly qualified doctor will sort you out. ... And if we're full, we will get you sent to a hospital that will take care of you."

Temporary diversion of services is not unusual for hospitals, Sen. Ned Claxton said Tuesday. The Auburn Democrat practiced family medicine for nearly 40 years in the Lewiston/Auburn area and ran CMMC's family medicine residency program for eight years.

Claxton said CMH leadership told lawmakers at a meeting Friday that it was facing "staff issues that have only gotten worse recently." He also said that the financial impacts of the pandemic and concerns over repayment of a federal loan were topics of conversation.

CMH requested the meeting with local legislators, which included Claxton, Sens. Jeff Timberlake, R-Turner, and Nate Libby, D-Lewiston, and Rep. Kathleen Dillingham, R-Oxford, to "keep the delegation posted," Claxton said.

Claxton declined to provide a list of CMH's representatives at the meeting.

"Specifically, they wanted us to understand that this was likely going to affect access for patients and care, and that was the major concern of all of this," he said.

If staffing shortages persist, CMMC is developing a "contingency plan" that would cut back on patient capacity at the hospital. This would include cutting back on the number of beds on the medical floor by about 40%. It would also decrease its capacity in the intensive care unit.

Claxton said the Maine legislative delegation is drafting a letter to the state's congressional delegation to ask for additional resources or federal aid, such as forgiving or changing the repayment schedule of CMMC's Medicare Advance Payment loan.

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