Eastport Memorial Nursing Home (EMNH), one of only three nursing homes in Washington County, is contending with statewide changes to how nursing homes are reimbursed. The challenging new reimbursement rate will require cost saving measures for the facility, which employs between 55 and 60 people.
      Until January 1 of this year, EMNH was reimbursed by the state based on the "island rule," a formula designed to help ensure the survival of island and remote facilities serving a large concentration of MaineCare residents. However, the Maine Department of Health and Human Services (DHHS) discontinued this designation as part of a comprehensive rate reform. As a result, there is now just one blanket category of reimbursement for all nursing homes statewide.
      Maine's new one size fits all MaineCare reimbursement system implements an across the board base rate for all nursing homes at $232.01 per resident per day. This rate is subject to adjustment based on the level of care required by residents. Meanwhile, other costs that are considered "routine costs" such as food, laundry, utilities and administration will be reimbursed at a rate of $137.20 per day. Any costs above and beyond the state approved levels will no longer be reimbursed. The new rates will take effect in 2026.
      For 2025, the state is implementing a bridge rate for EMNH at $244.86 per resident and $181.65 for routine care. Additionally, "Eastport and all qualifying facilities will be able to earn a portion of a new quality bonus pool that would be in addition to their rate," according to Lindsay Hammes, press secretary for DHHS.
      As the island rule involved settling costs at the end of the year, Hammes points out that the new billing schedule could be beneficial in some ways. "Under the new rate system, direct and routine costs are no longer subject to cost settlement at the end of the year, so Eastport's administrative costs should decrease and their revenue for the year is more predictable."
      The changes are being implemented against a backdrop of nursing home closures. Despite Maine having the oldest population of any state in the nation, during the past two decades more than 25 nursing homes - largely concentrated in rural areas - have closed across the state. Another, the Mercy Home in Eagle Lake, is scheduled to close in April of this year. In Washington County, nursing homes in Calais, Lubec, Jonesport, and most recently Milbridge have closed. Only the Maine Veterans Home and Marshall Health Care Facility in Machias and EMNH remain.
      The loss of the island rule presents a challenge to EMNH, a small community based independent nonprofit guided by the following mission statement: "Inspired by our core values of dignity and respect, Eastport Memorial Nursing Home is committed to providing the highest quality of care in a safe, loving, compassionate and home like environment."
      "Our mission statement says it all," says Tessa Ftorek, who currently serves as president of the board. "Our board is comprised of dedicated local residents, all of whom volunteer our time to help ensure that our 26 bed nursing home remains a vital part of the community able to serve those in need of care."
      "We have confidence in our very capable administrator, who is working to identify areas where we can reduce spending while prioritizing the needs of our residents. An integral part of the plan will be a fundraising appeal to seek support from the communities that have been touched by the nursing home and the care it has provided over the years," Ftorek says.
      "We are determined not to allow EMNH to become a statistic, as have so many rural nursing homes in Maine. The safe caring home we provide to some of our most vulnerable citizens is far too valuable to lose," adds Kevin Raye, who formerly served as president of the EMNH board and now serves as its vice president. "Like many in Eastport and the surrounding area, most of our board members were born in this building when it was Eastport Memorial Hospital and have had loved ones cared for here. We feel an obligation to do all we can to make sure EMNH is here to serve our current residents and those who will need care in the years to come."
      "EMNH has a dedicated staff, an engaged and committed board and has long enjoyed strong support from the community and the families of those who have been served by the home over the years," says Administrator Jane Hanson. "While the new reimbursement formula is challenging, we have already begun employing a range of cost saving measures. For example, rather than contracting with agencies for costly traveling nurses and CNAs to cover open shifts, we are offering extra shifts to our in house staff, who know and are familiar with caring for our residents." In addition, she notes, "We recently purchased three beds from a long term care facility about to close, which saved us more than $6,000 as opposed to buying brand new beds."
      "In the final analysis, between the proactive cost saving measures we're taking and support from people in our local communities, I'm confident we will meet the challenges we are facing and will continue to provide the high quality care our residents deserve," Hanson says.