Rose Lundy: Rise in contract staff key sign that nursing homes are struggling

One month after a Maine Monitor investigation highlighted the problem, five facilities shut their doors.
A nurse walks past a desk within the interior of a nursing home
A nurse at St. Mary's D'Youville Pavilion in Lewiston walks past a nurse's station. As workforce challenges grow, Maine nursing homes in recent years increasingly have turned to outside agencies to meet staffing requirements. Photo by Garrick Hoffman.

One month after The Maine Monitor published an investigation into rising rates of contracted staff in nursing homes, five Maine nursing homes announced they were closing due to staff shortages.

A four-month joint investigation with The Investigative Reporting Workshop, published on July 25, found that Maine’s 93 nursing homes increasingly relied on outside agency nurses and certified nursing assistants to fill staffing gaps in the years leading up to the COVID-19 pandemic. 

Contracted hours for certified nursing assistants in nursing homes across the state nearly doubled between 2017 and 2020.

One problem with that is agency workers can be expensive for facilities to employ and traditionally were used as a stopgap during emergency shortages. Today, they increasingly are becoming the norm in Maine as nursing homes struggle to find qualified candidates for permanent positions.

The Maine Monitor published its investigation in July. By the end of August, five nursing homes announced they were closing.

Four of the five shuttered nursing homes had recorded among the highest increases in the percentage of their direct care hours done by contracted CNAs between 2017 and 2020. 

Experts told The Maine Monitor that the pandemic exacerbated this existing workforce crunch. Nursing home jobs nationally are down 14% while other health care sectors have mostly recovered since the early days of the COVID-19 pandemic, according to the American Health Care Association.

Including the five closures this year, 18 Maine nursing homes have closed in all since 2012, according to records from the Maine long term care ombudsman program. 

Angela Westhoff, president and CEO of Maine Health Care Association, which represents Maine’s nursing homes, said it’s alarming that nursing home jobs aren’t recovering when demand for those services is expected to grow.

“It paints a very dramatic story for the future,” Westhoff told the Monitor last month. “I don’t believe that there’s enough beds and space available to cover the needs.”

Here are links to our two stories on this topic:

Nursing homes face ongoing staff shortages – a problem that predates the pandemic 

Tiny Coopers Mills reeling in the aftermath of nursing home closure


Rose Lundy

Rose Lundy covers public health for The Maine Monitor. She is a 2020 Report for America corps member, and a 2022 ProPublica Local Reporting Network fellow. Rose previously covered politics and local government at The Daily News in southwest Washington. She grew up in Minnesota and graduated from the University of Wisconsin.
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