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  • Staff photo by Don Himsel

    Milford Medical Center, Milford.
  • Staff photo by Don Himsel

    The emergency entrance for ambulances at Milford Medical Center.
  • Staff photo by Don Himsel

    Milford Medical Center, Milford.
  • Staff photo by Don Himsel

    Milford Medical Center, Milford.
  • Staff photo by Don Himsel

    Milford Medical Center, Milford.

  • Don Himsel photo

    St. Joseph Hospital is getting ready to renovate Milford Medical Center.
  • Staff photo by Don Himsel

    Milford Medical Center, Milford.
Tuesday, April 24, 2012

St. Joseph mulling future of Milford Medical Center

MILFORD – The status of the Milford Medical Center is up in the air as its owner, St. Joseph Hospital, decides how to upgrade the state’s only free-standing emergency department.

“The only decision we’ve made so far is to invest in it, in a significant and substantial way … to figure out how we might improve the facility,” said Melissa Sears, vice president of strategy and business development for St. Joseph Hospital. “What we will do and how we will do it has not been determined.”

The Milford Medical Center has been part of the Souhegan Valley for nearly four decades.

The hospital has created an online survey and will hold focus groups.

“We want to make sure we have the community involved in what we ultimately do. It’s going to be at least a year before we even quantify what it is we’ll be doing out there,” she said.

One possibility likely to be examined involves turning the center into an urgent care facility. That would remove emergency services, meaning it would no longer accept emergency calls by ambulances. It also probably would remove payment coverage by Medicare and Medicaid.

Milford Medical Center was opened in 1977, using a building commonly called “the barn,” which dates back to the 1920s, Sears said.

It has been upgraded several times since, including an expansion in 1985 and in 2005, with the opening of an adjacent Medical Office Building, which holds physicians’ offices.

Sears said the medical center is due for an upgrade, which has led to discussion about its future direction.

It sits on roughly three acres of property on busy Nashua Street, less than a mile from the Milford Oval.

Milford Medical Center is the only state-licensed, free-standing emergency department in New Hampshire; all others are attached to hospitals.

It operates 16 hours a day, 365 days a year, offering walk-in care for “minor emergencies as well as the initial diagnosis, treatment, stabilization and transfer of the more seriously ill or injured persons,” said the hospital.

It offers laboratory, X-ray and ultrasound services for emergency and outpatient use, as well as pediatric and OB-GYN doctors, rehabilitation, midwives and other services.

An urgent care facility, by contrast, offers fewer types of services. Under state administrative rules, it is not required to have a physician on staff.

An important point is that urgent care facilities generally aren’t certified for federal Medicaid and Medicare payments, unlike emergency rooms. They also often require different levels of co-payment and deductible from insurance plans.

Urgent care facilities are part of a spectrum of health-care alternatives to traditional hospitals and doctors’ offices that are becoming more common.

The state does not differentiate among these clinics in terms of licensing.

“Often times we find little difference in services between walk-in care and urgent care,” said John Martin, manager of the bureau of licensing and certification for the Department of Health and Human Services.

The key is that a person can walk in without making an advance appointment, and get care “without the expectation of creating a provider-patient relationship,” Martin said.

Doctors’ offices, where a long-term relationship is created, do not have to be licensed by the state.

Any change in the status of Milford Medical Center would require inspections by the state for clinical and life-safety issues, but probably would not require obtaining a Certificate of Need, which is a far more cumbersome process. It’s hard to say for certain, however, because of the Milford Medical Center’s unique status as a free-standing emergency center.

“This would be a first time,” Martin said.

David Brooks can be reached at 594-6531 or dbrooks@nashuatelegraph.com.