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Deer Isle nursing home's struggles show COVID-19's domino effect on Maine health system

Bangor Daily News - 9/2/2021

Sep. 1—Local leaders are scrambling to find a solution to the impending closure of one of Hancock County's few nursing homes as rising COVID-19 cases exacerbate staffing shortages there and stress hospitals dealing with an influx of critical patients.

The Island Nursing Home in Deer Isle announced on Monday it would be closing its doors at the end of October after struggling to find staff for years, according to a notice from the home's board. A lack of housing in the area made the situation more severe and the facility has vowed to find placement for its 60 residents.

The announcement came at a challenging time for health care providers squeezed by the pandemic. Nursing homes are subject to a federal mandate that will require staff to be vaccinated as soon as September's end. Some providers were already nervous about the potential staff effects of Gov. Janet Mills' broader mandate. The Deer Isle home's closure could also foretell greater challenges for hospitals already crunched for space by the pandemic.

It sent "shockwaves" through the community, according to Rene Hudson, the executive director of the Healthy Island Project, which does health outreach in the Deer Isle-Stonington region. The group has helped find housing for temporary workers at the nursing home. Advanced warning could have given local parties a chance to rally around the agency, she said.

"Families are now in distress, trying to find care and how far away that will be," Hudson said.

The nursing home situation is "the untold story" behind a shortage of intensive care unit beds in recent days, said Steven Michaud, the president of the Maine Hospital Association. Last week, Maine tied a record for the most COVID-19 patients in ICUs with 71 and had roughly 10 percent of critical care beds open, driven by normally high summer patient counts and a surge in cases.

Patients who do not have COVID-19 have been staying in hospitals longer because nursing homes do not have the staff or the capacity to take them, making it harder for hospitals to adapt to even small increases in COVID-19 patients, Michaud said on Monday.

He said the situation is "scary" and remains unpredictable with cases still relatively high and the mandates for health care workers on the horizon.

"I don't normally use the word 'scary,' but when I say 'scary,' it's because of that," he said. "How do you manufacture staff that's willing to come in?"

Staffing challenges are far from new in Maine, but they are becoming more evident as stressors on the health care system persist, said Angela Westhoff, the president of the Maine Health Care Association. She said some workers plan to leave their jobs due to the vaccine mandate that her group supported, but added that increased flexibility around when workers need to be fully vaccinated could help facilities hire new recruits or keep current employees on.

In Deer Isle, Hudson said she and other community members have arranged a meeting with Island Nursing Home's leadership, hoping Monday's announcement was not the "last word" on the facility's fate. Matthew Trombley, the home's executive director, forwarded the board's announcement but otherwise did not respond to requests for comment.

Finding another option may be difficult for locals: There are 22 residential care facilities in Hancock County able to provide different levels of care, but only three licensed nursing homes authorized to provide skilled medical care, according to the Maine Department of Health and Human Services records. The other two are in Ellsworth, more than 40 minutes away. There is just one assisted living facility, which can provide a lower level of care.

The region has seen at least two nursing homes close in recent years. The Penobscot Nursing Home closed after it lost its Medicaid and Medicare certifications in 2014 after years of effort by the state to close it and report deficiencies. The Sonogee nursing home in Bar Harbor closed in 2019, citing declining residencies and required minimum wage increases.

The two-year budget passed earlier this year included an increase in state payment for direct care and support workers to 125 percent of the minimum wage. It is a good start to fixing the problem, said Brenda Gallant, but it may not alleviate the immediate crisis. She said short-term fixes could come in the form of housing assistance or childcare subsidies.

In the meantime, "thousands" of hours of direct care work are going unfilled across the state, Gallant said, and some nursing homes are reducing their censuses as staffing remains challenging.

"That means those that qualify for those services may not get those services," she said.

BDN writer Michael Shepherd contributed to this report.

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