After 53 years of service to the community, the Oceanview Nursing Home and Residential Care facility in Lubec will be closed permanently on August 29. Administrator Nathan Brown gathered staff, residents and family members on Thursday, June 26, to share the news that one of the last independent, family‑owned facilities in Maine will be shutting its doors.
     "We were able to pull off an amazing balancing act for a number of years, under very unfavorable conditions, and became one of the highest quality facilities in our state," he says. "Unfortunately, after our last wage increase in 2011 our point of equilibrium was raised to the point that we needed to average 34 residents to maintain, as we always had, a census we have not seen at Oceanview since December 2013."
     When Oceanview was started in 1961 it had 50 bed rights. It now has 48 and is functioning as a 39-bed facility. "We were never at full capacity; that's hard to do in this area," Brown explains. The 26 residents at Oceanview will start the transfer process with Brown's assistance. He has been in contact with regional facilities in Washington and Hancock counties finding out the number of beds available at each. He has been looking at where each resident is from and what location might be the best fit for them, their family and their health needs.      "With all the empty beds in Washington and Hancock counties, finding placement won't be especially difficult, but it's inconvenient." The changes ahead will be hard on the residents, some of whom have been at Oceanview for a long time.

Economic impact
     The economic impact of the closure will be significant. Oceanview's annual budget has ranged from $1.8 million to $2.2 million depending on the year, with the 2013 payroll coming in at $1.3 million. "The annual payroll is where the impact is going to hurt the worst for folks locally," Brown says. There are 46 staff currently employed, and in the past that number has averaged out at 53. Of those 46 staff, four could probably retire, but "for most they're going to have to find work."
     Brown is proud of the facility and the team that has worked so hard over the years to provide care for loved ones. "I cannot speak highly enough of the people we have been fortunate enough to work with through the years." In one way or another he has been involved in the facility since his first job taking out garbage at age 8. Brown's parents, Larry and Margaret Brown, bought the facility in June of 1977. It was founded in 1961 by Lawrence and Evelyn Dorr of Machias. In 2001 Brown became the administrator.
     The closure will be another blow to the residents of Washington County, who lost the Calais‑based Atlantic Rehabilitation and Nursing Center in 2012. The Calais facility was licensed for 52 beds, had 41 residents, 90 employees and a payroll of about $3.5 million when news of its closure first made the rounds in January of that year. Many of the reasons for the Calais facility's closure are similar to the reasons that Brown lists.
      At the time of the Calais closure then Senate President Kevin Raye stated, "Today, more elderly residents receive in‑home services that allow them to stay in their own homes, and others live in assisted‑living facilities that do not offer the level of medical care provided in nursing homes, and Medicare‑reimbursed rehabilitative services are available in hospital settings.  Together with low Medicaid reimbursements, these factors are challenging nursing homes, particularly those in areas with a high percentage of Mainecare‑eligible patients."
      Brown adds the following to the list: the lack of local support. Of the 26 residents, only a handful are from Lubec. "The biggest thing is -- none of this had to happen if people would choose local providers." He likens it to people wanting the convenience of a local hardware store but running off to the big-box stores for their major purchases. The same type of thinking has been happening with healthcare choices. Rather than utilizing local facilities for nursing, rehabilitation and therapy, patients are choosing to go to the major hospitals where referrals don't usually swing patients back to their local options.

The juggling act
     The writing was on the wall since last August, says Brown. "I knew things weren't looking too bright." In October 2013 the facility was put on the market for sale. "The past couple of years a number of factors played into eliminating most of the reserve we had built. In 2011 there was enough to cover all the debt, all the earned time balances, and still go a month without getting paid. By last summer we were down to covering operations.      By January 2014 we had to take a line of credit to ensure we had the funds to cover our payroll."
It's been a juggling act since then. Spending cuts, reducing hours and staffing and inventory -- none of it helped even though the facility received its third deficiency‑free survey in the past seven years, a particular testament to the excellence of the staff, Brown adds. But by May Brown knew that come the fourth week of July there was no plan in place when the general fund was forecasted to be depleted and payroll, bills, earned time and debt would not be covered.
     "No one in our area or abroad had any interest in our facility as a functioning entity. All the other local owners packed up years ago. Bleeding out was on the horizon and we had no plan." Brown outlines the two options: taking on more debt to pay down debt in a vicious cycle that would end badly or liquidate to repay obligations. He hired a lawyer to help get the word out around the state that the facility's Mainecare revenue stream, in the form of the bed rights, was available. On Thursday, June 19, word came through that there was a buyer for the bed rights.
     Brown says, "No one should fault our hospital system, regulatory agencies or legislators for what occurred at Oceanview, or what has been occurring in our industry. If fault exists it is in the market we attempted to function in, and my inability to make people consider Oceanview to be a valued enough and needed enough part of it." He adds, "No local business, large or small, fully controls their own fate. It is customers who ultimately determine their local economy's future with every choice they make, or allow someone else to make for them." He adds, "Choose local, protect your community's resources, and they will be there the next time you need them."
     Over the next two months Brown will work with residents and their families to find new homes and will work with staff to wind down affairs. After having spent so many years involved with Oceanview, the change is difficult for him to absorb. "I have had a hard time thinking beyond the process of closing. I'm really tired right now. I need to make sure I take care of everyone else first and then take care of myself."