ElderCare Network Network of Lincoln County’s Boothbay Green notified residents and their families by letter Oct. 23, the facility will be closing and the property put on the market Dec. 22. ElderCare is a nonprofit that has operated over 20 years and has six facilities between Boothbay, Damariscotta, Edgecomb, Wiscasset, Round Pond and Waldoboro. Boothbay Green, at the corner of Country Club Road and Route 27, has six residents and has been active for nearly 20 years. ElderCare’s Jefferson facility closed in February.

ElderCare Director of Operations Kathe Cheska said in an interview with the Boothbay Register, the closure of Boothbay Green is a consolidation into the remaining five facilities, with all Boothbay staff keeping their jobs and with the four residents being offered spots at one of the five other facilities.

Cheska said the two main reasons Boothbay Green is closing began long before COVID-19 – a staffing shortage and budget shortfalls. Due to COVID-19 related protocols and costs and the budget issues she said are typical of state-funded healthcare, Cheska said the facilities have not been able to keep spots filled and the cost of care is going up. “For a long time we couldn't take any new residents and now there's quite a level of quarantining which I imagine may increase.”

ElderCare Medical Director and President of the Board of Trustees Doctor Chip Teel said despite the leadership of a loyal group of caregivers who have been with ElderCare for most of its history, the facilities are still on the verge of inadequate caregiving due to the healthcare staffing shortage spanning nearly a decade. COVID-19 has meant fewer caregivers are expressing interest in jobs and vacancies persist due to the health concerns of staff, residents and potential residents.

Though ElderCare’s mission is to provide quality assisted living care for private-pay as well as low-income elders, Teel said roughly 90% are on state assistance (long-term Mainecare) and reimbursement rates are about 40% of the cost of care.

“The math is pretty ugly. The state pays us now about what they paid us 20 years ago and we've made ends meet by being very frugal over a long period of time,” said Teel.

ElderCare tries to make up for the shortfalls by fundraising which has increased by 20 times in the past five years, said Teel. However, ElderCare was still forced to appeal to the Maine Department of Health and Human Services to keep Jefferson Green open. Months later, the nonprofit returned to Augusta to announce it was on the verge of closing Boothbay Green.

“Still no relief,” said Teel.

DHHS spokesman Jackie Falwell told Boothbay Register, “Over the years, MaineCare has used varying methods to determine reimbursement rates to providers, which has contributed to a rate system that’s fragmented and outdated. Under the Mills Administration, DHHS recognized the need for improvement and embarked on a process to create a comprehensive, streamlined and coherent system that will support MaineCare members' access to high value-services.

“Maine DHHS is in the midst of this evaluation, which will include developing a priority list of services that require rate assessment, a proposed process for updating methodologies, and recommendations for streamlining and rationalizing the rate-setting system,” Falwell continued. “As this evaluation continues, Maine DHHS is reviewing options to support this facility and its residents.”

House 89 Rep. Holly Stover – representing Westport Island, Southport, Boothbay Harbor, Boothbay, Edgecomb and part of South Bristol – is on the Joint Standing Committee on Health and Human Services. The committee issued a commission for a study of long-term care workforce issues. The work concluded in February and recommended an increase in long-term healthcare workers’ starting wages to at least 125% of minimum wage.

“We made many recommendations about rate setting increases primarily to address low wage earners who provide direct care, but also as a way to sustain the whole system.”

Adjusting rates will help with the cost of providing care and increase the amounts certain providers are reimbursed, said Stover. Whether or not the rate changes will help ElderCare’s situation is not clear, Stover said. “We just can't know, but I think we can agree that the region does not have a sufficient number of beds that are affordable and accessible to people who don't have the resources for private pay care. This problem with a continuum of care for elder services isn't going to go away. In fact, it's going to grow exponentially.”

Stover said the legislature’s failure to reconvene will soon make all bills resulting from the committee’s recommendations moot as well as over 400 others still waiting on the House floor. In the meantime, Stover said issues like ElderCare’s decision to close Boothbay Green are frustrating. “The less a facility is paid on a daily rate, the less they're able to pay their workforce. It's not just one single problem and the tragedy in all of this is this peninsula loses six affordable assisted living beds we desperately need.”

Teel said he wants  elder visibility and importance to be the first thing people see when they come into Boothbay, but ElderCare needs to be sustainable and he sees no way around selling the Green.

Said Teel, “This has been a long time coming to figure out how to meet the challenge of financial stability and staffing … and the big picture is ‘What are our communities going to do to support our elders?’ … I think it is very appropriate for the state and the county and the town and philanthropists to support these elders who need help, not because of anything they did wrong in their lives and not because they didn't save well enough, but because they lived long enough to run out of their money. They need some help from somewhere and that's what's driven us.”