Presque Isle Healthcare Center earlier this month. The facility is one of 20 in Maine owned or managed by First Atlantic Healthcare. Credit: Cameron Levasseur / BDN

The owner of 20 Maine nursing homes and assisted living centers is in the process of selling its facilities to an out-of-state healthcare group.

First Atlantic Healthcare, which owns or manages nursing, rehabilitation, long-term care and assisted living facilities from Caribou to Saco, is in the early stages of transitioning ownership to Links Healthcare Group, officials with both companies confirmed to the Bangor Daily News.

If finalized, the sale would mark another sizable shift in Maine’s nursing home landscape, which has been in turmoil for more than a decade. One in 4 nursing homes in the state have closed since 2015, shrinking the options available for families and creating a greater travel burden for care.

Based in San Diego, Links Healthcare operates at least 32 facilities between California and Tennessee.

The sale could be completed before the end of the year, according to Jennifer Clarke, an executive administrative assistant at First Atlantic. It will require state approval.

Clarke declined to share further details about the transaction, but said, “Our residents and their families will continue to receive the same safe, compassionate, and high-quality care they have come to expect from us today and into the future.”

First Atlantic’s holdings are spread across nine Maine counties and encompass more than 1,300 beds. It operates facilities in Lincoln, Saco, Freeport, Portland, Bangor, Dover-Foxcroft, Caribou, Presque Isle, Dexter, Millinocket, Waterville, Machias, Skowhegan and Lewiston.

The company jointly runs six long-term care facilities with Northern Light Health, including some it acquired within the last two years. Northern Light said it has “appreciated the collegial partnership we have enjoyed with First Atlantic through the years.”

“The company’s founders are ready to fully retire and we wish them well,” Northern Light spokesperson Suzanne Spruce said. “We are heartened that First Atlantic has taken steps to preserve access to care for the residential communities throughout Maine.”

Links Healthcare Group co-founder and co-CEO Toby Tilford confirmed that his company is working toward acquiring First Atlantic’s healthcare centers when reached by the BDN this week, but did not share further information.

The rate of serious deficiencies in Links Healthcare’s nursing homes in the last three years is less than half of the national average, according to Nursing Home Inspect, a search tool of nursing home inspection records published by the nonprofit newsroom ProPublica. First Atlantic’s serious deficiency rate is even lower, though the data does not include all of the facilities it operates.

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