Tom Nelson is pictured at his Skowhegan home with his dog, Grady, on Friday, Sept. 3. Credit: Michael Shepherd / BDN

A sudden medical emergency had Tom Nelson and his family preparing to say goodbye to his 96-year-old mother in late August. They now face the loss of her home.

Nelson’s mother, Lorraine Nelson, went into assisted living nine months ago after the “fiercely independent” woman lived alone in an apartment for 17 years following her husband’s death. A recent move into the Somerset Rehabilitation and Living Center in Bingham meant she would still be close to her three sons and family and get the care she needs.

Lorraine Nelson had a health emergency last week. This week, her Bingham nursing home closed, leading her family to fear that another move could affect her health. Credit: Courtesy of Tom Nelson

Tom Nelson worries his mother cannot handle another move. Administrators at the nursing home have told him their goal is to place his mother in another home within 60 miles, a prospect that could put far beyond a roughly 30-minute drive from his Skowhegan home to Bingham.

“We would make time to go see my mother, but 60 miles away, that would just be devastating,” he said, noting his brother can walk to the Bingham home.

It is a challenge an increasing number of Maine families are facing as three nursing homes announced planned closures within three days last week. Many families have little control over the process of placing relatives in new care settings, spurring anxiety as long-standing staffing problems in the industry have come to a head during the COVID-19 pandemic.

The wave of closures has been attributed to many factors, including a national workforce shortage, Medicaid reimbursement rates that have long left wages for crucial staffers competitive with retail and fast-food jobs paying more now and pandemic-related burnout. About 94 percent of facilities reported staffing shortages in a Maine Health Care Association survey.

But another factor is the anticipation of staff losses due to vaccine requirements by the federal government and Gov. Janet Mills. The governor on Thursday extended the enforcement deadline for her mandate for another month with $146 million in state and federal supplemental funding on the way to nursing homes.

The Mills administration has said the mandate — one of the few in the nation without a testing alternative for unvaccinated workers — is the best way to defend against cases at health care facilities, where over half of Maine’s active outbreaks are located.

Representatives for North Country Associates, the company that owns the Bingham home, did not respond to a request for comment. But it reported just a 42.2 percent staff vaccination rate as of July 31, placing it among the worst in the state, according to state data. Nelson said he was told the mandate was a major factor in the closure. While he knew staffing was an issue, he saw Mills’ requirement as the main problem, placing no blame on the unvaccinated workers.

The impending closures of that home and the Country Manor Nursing Home in Coopers Mills were made public on Wednesday. Two days before, the Island Nursing Home in Deer Isle announced it would be closing after struggling to find housing for temporary workers. All three are expected to close at the end of October.

Facilities cannot close until they place all residents, said Brenda Gallant, Maine’s long-term care ombudsman. Her office has reached out to the homes’ residents to try and assist them with finding the best placement. For some, that might mean moving out of state to be closer to family, some staying close or with spouses. Staffing difficulties will make any placement a challenge.

“Right now, nursing homes are maintaining a census level their staffing can accommodate,” she said. “If we’re asking them to increase that, they’re going to need more staff.”

Gallant said she has not seen three nursing homes announce closures at once in the roughly dozen or so closings she has seen since 2012. She hoped some residents could be placed together, or that staff might move to a new facility, keeping a sense of familiarity with the move.

That is what Rhonda Gallant wants most for her aunt, who is in her mid-80s and lives at the Island Nursing Home. She was placed in Bangor until she needed a higher level of care two months ago. That put Gallant and her family about half a mile away from her aunt, which she said has been “a blessing.”

She said she worries another change will make her aunt’s health deteriorate. Gallant is hoping she will be placed in Ellsworth. That’s where the last two Hancock County nursing homes are.

“Now, we don’t know where she is going to end up,” she said.