Low Pay Behind Staggering Shortfall in Nursing Home, Direct Care Hours in State 

Low pay and inadequate benefits are the drivers of high turnover and burnout among direct care workers in long-term care, including nursing homes, resulting in a staggering shortfall in care hours required versus those actually delivered, according to a new report.

The report released Tuesday and produced by the Maine Center for Economic Policy (MECEP), in collaboration with the Maine Council on Aging, follows a prior report that shed light on significant gaps in care services for seniors and adults with disabilities across the state. 

Analyzing data from state departments and service hubs, the report’s findings suggest that each week, more than 23,500 hours of care for older adults under state-funded and MaineCare programs go unstaffed. The figure is likely underestimated due to reporting discrepancies and exclusions of individuals ineligible for public programs, the researchers noted.


Addressing this shortfall necessitates approximately 400 additional personal support specialists and 187 nurses.

The demographic trends have exacerbated these challenges. Maine’s aging population increasingly favors home care over traditional nursing home settings, which have seen a 19% decline in facilities and a 21% decrease in patient capacity since 2010, the largest drop among New England states according to the Boston Federal Reserve’s analysis.

The shortage of nursing home beds has not only strained available resources but also impacted hospitals, where an estimated 200 patients per day in Maine linger due to insufficient nursing home placements, the report concludes.


MECEP estimates that meeting demand will require at least 200 additional nursing home beds and 157 more workers.

In response to these challenges, Maine has implemented several policy measures. Initiatives include setting MaineCare reimbursement rates for direct care workers at 125% of the state minimum wage and allocating federal American Rescue Plan Act funds towards recruitment and retention bonuses. The state’s Jobs and Recovery Plan introduced programs like Respite for ME, offering financial support to family caregivers.

Looking ahead, MECEP recommends further increasing reimbursement rates to 140% of the state minimum wage to improve workforce conditions. The organization also proposes innovation grants to explore recruitment strategies and calls for enhanced data collection to better gauge vacancies and turnover rates.

Moreover, the report suggests creating an advisory board comprising care workers, recipients, and providers to advise policymakers on compensation and retention strategies.

The personal testimonies within the report emphasize the human impact of these systemic challenges, highlighting disparities in pay compared to other professions as well as showing the importance of subsidized training to bolster workforce entry.

News of the report was published in the Maine Morning Star.

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