In increasing numbers, senior citizens in Massachusetts are turning to assisted living or living at home with assistance, and those choices are exacerbating problems in the nursing home industry. "There will be additional closures," Health and Human Services Secretary Marylou Sudders told lawmakers at a fiscal 2020 budget hearing. One in four nursing homes have occupancy rates of 80 percent or less, which she said is "not sustainable," and the average occupancy rate is 86 percent. As the state's…