St. Andrews will no longer be a hospital and 50 employees will lose their jobs once changes – outlined July 30 in meetings with employees and in an employee newsletter – are approved.

Lincoln County Healthcare, the organization that manages St. Andrews and Miles Memorial Hospital in Damariscotta, will propose the changes to their parent organization MaineHealth.

The changes, if approved, would be effective April 2013.

About 50 employees will lose their jobs because of these cuts; about 100 employees will remain at St. Andrews.

"It is disheartening that community engagement was not a necessary element of Lincoln County Healthcare's action plan," Boothbay Town Manager Jim Chaousis said following the announcement. "The region has been working on community planning for months and significant information has been withheld. The Town of Boothbay will lobby for a period of community review."

No more emergency room: Citing low patient visit numbers, Lincoln County Healthcare concluded “maintaining two Emergency Departments in Lincoln County is unsustainable.”

They propose instead an urgent care center that will be open from 8.a.m. to 8 p.m. in the summer months and from 8 a.m. to 6 p.m. for the rest of the year.

Ambulances may not deliver patients to facilities without a 24-hour emergency room, and when the emergency department becomes an urgent care center, St. Andrews will lose its hospital status.

Skilled inpatient care: Because St. Andrews will no longer be a licensed hospital, inpatient care will no longer be provided.

Outpatient surgical services: Outpatient surgical services that were terminated in April will not be reinstated.

Boothbay, Boothbay Harbor and Southport town officials will meet with Lincoln County Healthcare CEO JIm Donovan and representatives of the Board of Trustees on July 31. MaineHealth is scheduled to review the plan on Thursday, Aug. 2.

For more on changes at St. Andrews, read the rest of our series:

Part I, A community waits

Part II, No longer a hospital

Part III, Hospital decisions explained

Part IV, Hospital transition begins

Part V, Ambulance service plans for ER closing

For the story told through community response, visit our Storify