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MMC submits application for state approval of $512 million project

March 18, 2017

Contact: Clay Holtzman
207‐662‐2196 /

The renovation and expansion project will address a chronic shortage of beds and modernize treatment facilities at the state’s largest medical center

PORTLAND, Maine – Maine Medical Center announced today that it has filed a Certificate of Need (CON) with the State of Maine for its planned $512 million renovation and expansion project. 

The state requires CON approval for all major investments in healthcare infrastructure. For this project, which was announced last fall, approximately $392 million of the investment Maine Medical Center is proposing is subject to review by state regulators.

“We are confident the Department of Health and Human Services’ Certificate of Need Unit will see that this investment is vital to our continuing ability to provide world-class care to those who choose the state’s largest major medical center,” said Rich Petersen, president and chief executive officer.

The balance of project costs not eligible for CON review includes approximately $50 million to be invested in outpatient facilities and another $70 million in non-clinical construction, primarily replacement of a large parking garage that has reached the end of its useful life.

In its application, Maine Medical Center detailed its role as the state’s leading provider of tertiary care. It noted that, as the Maine institution that treats patients with the most complex illnesses, it is seeing growth in both the volume and acuity of its cases.

“With the median age in Maine ranking as the highest in the nation, demand for services – especially those regarded as tertiary – is expected to continue to grow,” said the application. “Meanwhile, technology and evolving care standards are driving patients with more complex conditions to higher volume, tertiary care hospitals such as Maine Medical Center.

“The end result is that Maine Medical Center’s Case Mix Index, which is a Centers for Medicare & Medicaid Services (CMS) measure of how complex cases are at a given institution, is rising steadily. Admissions are also growing. Put simply, Maine Medical Center is seeing more patients, and those patients are sicker than those of the past. As the hospital with the largest market share of tertiary and non-tertiary patients in Maine, these trends are especially pronounced for Maine Medical Center.”

The application goes on to explain that these trends are impacting the hospital in a number of significant ways.

At the core of the need for the project is the fact that today many of Maine Medical Center’s patients require a private room, yet much of the hospital’s aging infrastructure includes double, or semi-private, rooms for patients.

“Many of the patients treated at Maine Medical Center today are simply too sick to have a roommate,” said the application. “This, combined with concerns such as matching patients in semi-private rooms by gender, on a typical day leads to 60 or more bed closures. Capacity is further strained because many licensed beds are set aside for a specific purpose, notably critical and intermediate care beds that can’t be made available outside of those needs.”

As a result, Maine Medical Center is experiencing a chronic shortage of available patient beds. The ongoing adult bed shortage frequently backs up Maine Medical Center’s Emergency Department, and the hospital has to carefully manage transfer requests from other hospitals, prioritizing the sickest patients and often leaving others waiting for an extended period of time for an open bed.
To address this, the project calls for the addition of 128 “universal” beds that can flex among standard, intermediate and critical care.

“This will go a long way toward addressing the capacity issues we are having,” said Petersen. “Single rooms are now the standard for hospitals because the patients we see today are much sicker on average than in the past.”

The application also pointed out that facilities for surgeries and other procedures are also under stress at Maine Medical Center, part of a larger challenge that comes with buildings that are nearing the end of their useful life.

“The vast majority of procedure rooms at the hospital are more than 30 years old. These facilities do not conform to current new building standards of size – they are about two-thirds the size of modern rooms – and supportive infrastructure such as prep and recovery bays, family waiting rooms and sterilization facilities are not properly suited to meet patient needs in the future,” the application said. “The project includes 19 appropriately-sized universal procedure rooms that can accommodate the latest technology as well as facilities that will better support pre- and post-operative care.”

The application details how current trends are likely to drive more patients to Maine Medical Center in coming years, something expected to happen with or without the expansion project. That growth is reflected in projected financial results, said the application, and that in turn should help to minimize the impact of the project on the hospital’s budget and pricing.

“Projected price increases associated with the project will largely reflect what has been requested in recent fiscal years from commercial insurers,” said the application. “However, modest incremental price increases above and beyond those sought in recent years will be necessary.”

Maine Medical Center plans to pay for the project through a combination of borrowed funds, reserves and philanthropy. Overall, said Petersen, the project’s impact on Maine Medical Center’s budget will be much smaller than other factors such as the fact that federal Medicare and Medicaid payments do not cover the full cost of delivering care under those programs.

“And though it is hard to calculate, there is definitely a cost associated with not doing this project,” said Petersen. “Our staff does an amazing job delivering world-class care in an outdated facility, but we lose efficiency when we have to work around those constraints. This project will support the great work that is done at Maine Medical Center and bring real value to our patients and the communities we serve.”

About Maine Medical Center
Maine Medical Center (MMC), recognized as the number‐one ranked hospital in Maine by U.S. News and World Report for 2016‐2017, is a complete health care resource for the people of Greater Portland and the entire state, as well as northern New England. Incorporated in 1868, MMC is the state’s largest medical center, licensed for 637 beds and employing nearly 6,500 people. MMC's unique role as both a community hospital and a referral center requires an unparalleled depth and breadth of services, including an active educational program and a world‐class biomedical research center. As a nonprofit institution, Maine Medical Center provides nearly 23 percent of all the charity care delivered in Maine. MMC is a member of the MaineHealth system, a growing family of health care services in northern New England. For more information, visit

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