A small community hospital in Lincoln County is expected to replace its emergency room with an urgent care center and eliminate other services, according to a newsletter sent Monday to employees.

Lincoln County Healthcare, which operates St. Andrews Hospital & Healthcare in Boothbay Harbor, has proposed shuttering the ER and ceasing inpatient care and outpatient surgical care by next April.

The move would eliminate 50 jobs, or about one-third of the hospital’s workforce, although some of those employees could be reassigned.

St. Andrews’ fate rests in the hands of the board of directors of MaineHealth, which is the parent company of Lincoln County Healthcare and a statewide network of hospitals and healthcare providers led by Maine Medical Center in Portland.

That decision is expected to come at a meeting on Thursday.

Jim Chaousis, town manager of Boothbay, said he hopes the board delays action, at least temporarily, to allow community members to weigh in on the impacts.

“No one knows exactly what is going on, but we do know that this plan has been in the works for several months,” he said. “They are a private business and we don’t want to dispute their reasons, but if we can provide them with more information maybe that would make a difference.”

Catherine Wygant, executive director of the Boothbay Harbor Chamber of Commerce, also hopes to delay a decision.

“We believe that the closure of the emergency facility at St. Andrews will have a reach far beyond anything we can imagine,” she said in a letter to board members. “We ask that you reconsider this decision … and engage with us and our members to seek alternative solutions to keep this valable resource viable.”

An impromptu public meeting has been scheduled for Tuesday evening at the hospital to further explain the proposal. Chaousis, Wygant and other local leaders are expected to attend.

Lincoln County Healthcare operates St. Andrews Hospital as well as Miles Memorial Hospital in Damariscotta. The organization formed in 2007 as a way to merge the two hospitals under one management team with one board of trustees.

Monday’s newsletter to employees said low patient numbers precipitated the change. For instance, the ER sees an average of 0.6 patients between the hours of midnight and 6 a.m. each day, compared with 2.8 patients at Miles Hospital.

“Given these numbers, maintaining two emergency departments in Lincoln County is unsustainable,” the letter reads.

An urgent care facility will take the ER’s place in Boothbay Harbor and will be open from 8 a.m. to 6 p.m. to treat lesser injuries. The Damariscotta hospital, which is about a half hour’s drive from St. Andrews, likely would take on more patients under the proposed changes.

“Because of the conversion of the [emergency department], St. Andrews will no longer be licensed to provide skilled/rehabilitation inpatient care,” the letter continued.

Finally, the letter read, “With an average of seven surgical procedures a week, the cost of maintaining an operating room at St. Andrews is prohibitive,” the letter said. Those procedures will be shifted to Miles Memorial or Maine Medical Center.

Scott Shott, a vice president with Lincoln County Healthcare said the decisions were not made lightly and many of the board members who were involved are longtime local community members.

Chaousis said he fully recognizes that if a new hospital were built today, it likely would not be built on a rural, coastal peninsula like Boothbay Harbor. But St. Andrews has been a important part of the community for more than 100 years, he said.

“This could be devastating,” Chaousis said.

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