LincolnHealth is working with Sandy River Company, a Portland-based non-profit senior care development firm, to come up with solutions to address budget shortfalls at the hospital’s senior living facilities.
During an interview on Monday, July 26, LincolnHealth President Cindy Wade said the hospital’s senior living facilities have been losing an average of $2.5 million each year for the past eight years because of staffing shortages and low reimbursement payments from MaineCare, Medicare, and private insurance companies.
“We’ve got to do something different. We know that’s not a sustainable model. We know we have to have sustainable care in this county. How do we do that?” Wade said.
Cove’s Edge, on the Miles Campus in Damariscotta, is certified for both long-term and skilled care. Long-term care is for people who need assistance from a caregiver for daily activities, as well as licensed medical care, while skilled nursing is more for short-term rehabilitation from injuries.
Wade said that very few people have insurance that covers true long-term and skilled care.
The hospital is reviewing several options with Sandy River, such as adding on to facilities and potentially consolidating the senior living facilities into a bigger, state-of-the-art space in Lincoln County.
Wade said the goal is to make sure that senior living facilities remain “available, high quality, safe, and affordable in the county going forward.”
Sandy River suggested an “economy of scale” model where a 96-bed state-of-the-art facility with all private rooms could potentially work better for the current staffing and reimbursement model in the hospital’s senior living facilities.
Wade said looking into a bigger facility seems to be the most viable long-term solution at the moment, as there is no space to add on to the facilities. Making all the rooms private would decrease capacity rather than increase it.
“You don’t have your economies of scale to be able to get to that level where you’re actually, hopefully, breaking even,” Wade said.
Sandy River has worked with Pen Bay Medical Center in Rockland for the last few years on plans for a new $19.5 million senior living facility that will replace two other aging facilities. The facility gained final approval from the Rockland Planning Board in April and the opening is anticipated for 2023.
Pen Bay, like LincolnHealth is part of the MaineHealth system.
LincolnHealth has been reviewing its senior living services and how to make them more sustainable as part of its annual implementation plan for the past three years.
Prior to the COVID-19 pandemic, the hospital worked with consultants to lessen the shortfall in the senior living budget line.
“The teams did an amazing job decreasing expenses, increasing what reimbursement we do get, and managing things a little differently. And we had a $500,000 shift,” Wade said.
The pandemic only exacerbated the problem, however, and the hospital is on track to lose over $4 million in that line of services this year, due to staffing challenges, increased costs, and the need for more supplies.
After COVID-19 arrived in March 2020, the facilities had to quarantine any new individual before they were admitted and many of the buildings didn’t have the space for that.
“You couldn’t just bring somebody into the facility. They had to be quarantined, you had to have a unit that could handle that with separate staff,” Wade said.
And now, because of trouble finding staff, many of LincolnHealth’s senior living facilities cannot be filled to capacity with new residents.
Wade said the hospital uses a formula for each facility to calculate how many more residents can be admitted if a certain number of new people are hired.
Cove’s Edge is currently only about 60% occupied and Zimmerli Pavilion and the Gregory Wing on LincolnHealth’s St. Andrews Campus in Boothbay Harbor need eight nurses and five certified nursing assistants to reopen fully.
LincolnHealth currently has 77 open positions, the highest Wade has ever seen.
She pointed to the new reimbursement model from MaineHealth as part of the solution to attracting more employees. The hospital system is raising the minimum pay from $14 an hour to $17 and giving nearly every worker at least a 2% raise.
“That’s not the golden ticket. Everybody wants more money, absolutely. We need to be competitive, we need to take care of the people that work for us today, and we need to be able to recruit for the future,” Wade said.
The hospital has been working with nursing schools for years and can help students through schooling and become certified for hospital work.
LincolnHealth is looking to provide more staff at the LincolnHealth Education Center on Chapman Street in Damariscotta so that 12 people, rather than eight, can be admitted into the nursing program there.
John Martins, spokesperson for LincolnHealth, said the center offers a free 10- or 11-week program to become a certified nursing assistant.
LincolnHealth works with all four high schools in the area and is looking to arrange for hospital employees to talk to students about career opportunities.
Martins gave an example of what makes LincolnHealth a special place to work.
“One of the things that happens here that is amazing to me is when there are shortages, like over at Schooner Cove in the kitchen, people … volunteer to go in and serve people. We’ve had such a shortage over there that some of our managers have been taking shifts,” Martins said.
“That’s something that I’ve never seen before and it’s really indicative of what makes this place special,” Martins said.
Anyone who is interested in a career opportunity with LincolnHealth or going to school to work in the medical field should call the hospital to review options, Wade said.
“It’s a great place to work. It’s in your community, great benefits, people are amazing, people take really good care of each other,” she said.
(Correction on Aug. 16: An earlier version of the article “LincolnHealth working with developer to address senior living challenges” online incorrectly reported that LincolnHealth is working with Sandy River Company to attract more nurses and nursing assistants to work at the hospital. LincolnHealth is only working with Sandy River Company to address senior living facilities issues. The Lincoln County News regrets the error.)
