A long-term care home in Lincoln is opting for a less staff-intensive path forward as it reduces its number of beds and continues running as an assisted living facility in an industry beset by staff shortages.
The parent company of Colonial Healthcare said this week that the facility would stop operating as a nursing home, citing insufficient reimbursement for services from the state’s Medicaid program and an unwillingness among employees to get vaccinated against COVID-19 before Gov. Janet Mills’ vaccine mandate for health care workers takes effect later this month.
The reduction in beds and switch follow recent announcements from three nursing homes — located in Bingham, Whitefield and Deer Isle — that they plan to close, with staff shortages a dominant factor. An assisted living facility in Biddeford also plans to shut its doors.
The looming vaccine mandate and the COVID-19 pandemic, during which nursing homes became sites of major coronavirus outbreaks, have exacerbated longtime staff shortages in long-term care. Most nursing homes cited those factors as reasons for employee departures in a summer survey by the Maine Health Care Association, the homes’ lobbying organization.
Some 85.8 percent of nursing home workers had been vaccinated against COVID-19 as of the end of September. Friday is the last day for health care workers to get the one-shot Johnson & Johnson vaccine to comply with the mandate, which the state will start enforcing Oct. 29.
The vaccination rate at Colonial Healthcare, which saw a coronavirus outbreak of about three dozen cases over the summer as the delta variant surged, was 69 percent at the end of last month. That outbreak was the result of unvaccinated people introducing the virus into the facility, said Andrea Otis-Higgins, chief operating officer of First Atlantic Healthcare, Colonial’s parent company.
Moving forward as an assisted living facility means Colonial Healthcare will have residents with less-intensive needs than those who require nursing home-level care. The state’s vaccine mandate for health care workers will still apply for staffers, but assisted living residents do not require as many employees to care for them, according to the Maine Health Care Association.
“The needs of the residents are not going to be as acute, and that’s by design in Maine,” said Angela Westhoff, the association’s president and CEO. “Maine reserves its nursing homes for the sickest of the sick.”
Nursing homes must have one direct-care worker for every five residents during daytime hours, one for every 10 during evenings and one for every 15 residents at night, according to state rules.
“Staffing levels are not the same in assisted living as what is required in nursing homes because the level of care required differs,” Westhoff said.
Colonial Healthcare, the only nursing home in Lincoln, currently has 60 beds devoted to nursing home-level care and 26 for assisted living. Colonial plans to grow its number of assisted living beds, with memory care as a potential service, Otis-Higgins said. First Atlantic will allow employees affected by the end of nursing home services to work in assisted living in Lincoln or at other company facilities, she said.
First Atlantic is working with the state’s Medicaid program to secure a reimbursement rate that allows it to expand assisted living services, according to Otis-Higgins, who described the factors that led to the changes at Colonial as “a catastrophic business failure.
“We had more leaks in the dike than we had fingers to plug them,” she said.
A number of Maine nursing homes have converted to assisted living in the past, though those changes happened before the COVID-19 pandemic. While Lincoln will see the loss of nursing home beds, and residents will have to be relocated, it’s encouraging that the facility isn’t shutting down, Westhoff said.
“The conversion ensures that residents in the community will have access to a viable long-term care option in assisted living,” she said.