Citing a lack of patients, a small community hospital in Lincoln County is expected to replace its emergency room with an urgent-care center and eliminate other services.

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

The changes would eliminate 50 jobs, about one-third of the hospital’s work force, although some of the employees could be reassigned.

Lincoln County Healthcare operates St. Andrews Hospital and 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.

Low patient numbers have precipitated the changes, according to a newsletter sent to hospital employees Monday. For instance, St. Andrews Hospital’s emergency room sees an average of 0.6 patients between midnight and 6 a.m. each day, compared with 2.8 patients at Miles Memorial Hospital.

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

An urgent-care facility would replace the emergency room in Boothbay Harbor, staying open from 8 a.m. to 6 p.m. to treat lesser injuries.

The hospital in Damariscotta, about a half-hour’s drive from St. Andrews, probably would take more patients.

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

Finally, it says, “With an average of seven surgical procedures a week, the cost of maintaining an operating room at St. Andrews is prohibitive,” so those procedures would be shifted to Miles Memorial Hospital or Maine Medical Center in Portland.

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

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

Jim Chaousis, the town manager in neighboring Boothbay, said he hopes the board will delay action, at least temporarily, to allow community members to weigh in on the effects of the changes.

He said he recognizes that if a hospital were built today, it probably wouldn’t be built on a rural, coastal peninsula such as Boothbay Harbor’s; but St. Andrews has been a important part of the community for more than 100 years.

“This could be devastating,” 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,” Chaousis said.

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

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

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 community members.