Sadly, Maine’s Nursing Home Crisis Is No Surprise, But It Is Still Solvable

(AUGUSTA, ME)—More than two years ago Senate Republicans began ringing the warning bell regarding the underfunding of Maine’s nursing homes and the resulting shortage of staff. In the many months since then, we have raised the issue more than two dozen times in press releases, floor speeches, op-eds, radio addresses, and in other ways. Each time the plight of nursing homes has fallen on deaf ears in Augusta.

As you can see from this extensive collection of pleas, arguments, and proposals, Governor Mills has doggedly resisted adequately funding nursing homes in Maine. Over the last three years of budget proposals, she has either increased their funding by no more than the required legal minimum or added no funding increase at all.

This week, three of the state’s Medicaid-funded nursing homes have finally given up the struggle and more are on the way out, leading to what the Maine Health Care Association (MHCA) fears may become a “cascade” of closures in an industry already buried in wait-list requests to house a growing number of Maine seniors.

The MHCA surveyed operators of its members’ 200 long-term care facilities and found that 95% were short-staffed, half of those to crisis levels. The two most often-cited concerns were pandemic fatigue and the Governor’s vaccine mandate. After years of chronic underfunding by the state and widespread staff shortages, the vaccine mandate was the last straw in an industry that has staff vaccination rates as low as 45% at some facilities.

It did not have to be like this. The vaccine mandate did not have to force a mass exodus of workers from the health care field.

It may not be too late to save others on the verge of closure.

Governor Mills’ extreme “take the shot or you’re fired” ultimatum to these workers is unnecessarily harsh. Only two other states—Oregon and Washington—have gone this far and even they allow exemptions that Maine does not. Sixteen states led by Democratic governors who are advised by a host of medical experts have vaccine mandates in place that require weekly testing for those who are not vaccinated. The federal government and cities like New York have also chosen weekly testing over job termination based on the advice from their health care experts.

In accordance with the President’s announcement, the federal government will issue its own vaccine mandate for Medicaid-funded nursing homes that will likely include a weekly testing option since the federal departments of Defense, Veterans Affairs, and Health and Human Services have all adopted this strategy.

During the August 12 press conference when she announced her mandate, Mills told reporters that this staffing shortage was not a concern. When asked by a reporter if she feared her actions would worsen the health care labor shortage, she replied, “Quite frankly if everybody does this, and we’re requiring all licenses to do it, there won’t be many places to go. People will not be able to quit their job and go to another job…I think [this] is beneficial from that point of view it’ll help employers and health care providers and I think it will help make sure that we have the highest quality health care in the state of Maine.”

Now that she has been made aware how badly she underestimated the damage that would result from her extreme mandate, the Governor can and should alleviate much of this damage and perhaps prevent further nursing home closures by joining 16 of her Democratic colleagues across the nation in requiring weekly testing, not firing, for health care workers who do not submit to vaccination.

Of the nearly 932 COVID-related deaths recorded in Maine, half have been among nursing home residents. Given the chronic underfunding and staff shortages under which they have had to labor, are these closures any surprise?

If she does not amend her worst-in-the-nation mandate, the collapse of the nursing home system in the nation’s oldest state will be the Governor’s health care legacy for generations to come, and she cannot say she was never made aware.

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