AUGUSTA, Maine — Two more Maine nursing homes announced plans to close this week as the effects of the COVID-19 pandemic and existing workforce problems collide, prompting fears of a “cascade” of closures that could reverberate in rural areas.
The impending closures of the Country Manor Nursing Home in Coopers Mills and the Somerset Rehabilitation and Living Center in Bingham were notified to the state on Monday and Wednesday, respectively, after the Island Nursing Home in Deer Isle announced plans to close on Monday.
Nursing homes broadly attributed high staff turnover rates in 2020 to the pandemic. Long-term care facilities have faced a range of challenges over the past 18 months, including strict COVID-19 protocols to prevent the spread of the disease, few visits for residents from family and relatives and many outbreaks that have infected dozens of staff and residents.
New factors are adding more stress. In a survey released Wednesday by the Maine Health Care Association, 94 percent of long-term care facilities said they had staff shortages. Nearly half described the issue as a “crisis” and they placed pandemic burnout and vaccine mandates as the top challenges facing an industry that has long struggled to find workers.
“I think there’s going to be a cascade of closures if we can’t get some financial relief to these facilities, but also think about a long-term strategy for the workforce problems,” said Angela Westhoff, the industry group’s president.
Gov. Janet Mills’ administration said on Monday that it plans to release $123 million in state and federal funding allocated for nursing homes and other direct care providers in the latest two-year budget that aims to address workforce issues, plus $23 million more for supplemental payments. Westhoff said earlier in the day that she did not know the state’s timeframe for the larger chunk of the funding, which was authorized in a budget bill this year.
One out of five providers reported having more than 20 unfilled positions right now in the association survey. Certified nursing assistants and direct care workers were most in demand, with 99 percent of providers reporting that they had job openings in those areas. More than half of facilities also reported openings for registered nurses, dietary staff and housekeeping staff.
Country Manor will close because of a preponderance of factors, including years of declining occupancy, a rural setting and staffing shortages, said Doug Gardner, vice president of operations for North Country Associates, the company that consults for the home’s owner and owns the Bingham home. But one final stressor was that six direct care and nursing staff members out of 58 staff in total said they would not be vaccinated.
Maine’s vaccine mandate for health care workers, which goes into effect Oct. 1 and will likely be mirrored by the federal government, could pose a challenge for nursing homes where a large share of the workforce remains unvaccinated. Seventy-two percent of facilities named the requirement as a reason for staff departures, while 80 percent cited burnout as a reason.
Vaccination rates continue to vary widely by facility. Somerset Rehabilitation and Living Center saw just 42.2 percent of its staff fully vaccinated as of the end of July, according to data reported to the state. Country Nursing Home and Island Nursing Home — the other two set to close — had rates of 73.3 percent and 74.1 percent respectively, slightly above the state average.
The most commonly cited strategy for addressing workforce challenges was increasing pay, the Maine Health Care Association survey found, with 86 percent of respondents saying they thought that would help. Eighty-three percent also favored sign-on bonuses as a means to attract workers.