DHHS Advances Support for Maine’s Nursing and Residential Care Facilities

February 28, 2022

Today, the Maine Department of Health and Human Services (DHHS) issued new MaineCare payment rates to nursing facilities, to be followed shortly by rates for residential care facilities (Private Non-Medical Institutions (PNMI), Appendix C), which increase funding by $12 million from January through June 2022. This includes the $4.5 million appropriated in the biennial budget for increasing rates, effective January 1, 2022, to support at least 125 percent of the minimum wage for direct care workers. It also includes funding for an initiative to reinstate a MaineCare “supplemental wage adjustment” of $7.6 million that will assist nursing and residential care facilities with labor costs through the rest of the 2022 fiscal year. This supplemental wage allowance was in place for state fiscal years 2019 through 2021, but had expired on June 30, 2021. Facilities can access these higher rates retrospectively to January 1, 2022.

The Department also has announced that it is responding to requests to give nursing and residential care facilities extra time, beyond June 30, 2022, to spend the $123 million supplemental payment DHHS made last fall to help address workforce issues associated with the pandemic. The Department will now allow until the end of the calendar year for expenditures of these funds. This will provide a bridge to the additional $25 million one-time COVID-19 payment proposed by Governor Mills in the supplemental budget for nursing and residential care facilities for fiscal year 2023. These special COVID-19 payments help with the extraordinary and potentially ongoing cost of caring for patients with COVID-19, as well as an expected ongoing need to support decompressing hospitals as the pent-up demand for care is met after the pandemic surges. Facilities can use this funding for recruiting, training, and retaining staff, among other uses.

The Department is currently calculating the facility-specific adjustments needed to support rates that continue the 125 percent of minimum wage provision in fiscal year 2023 and beyond. It is committed to fully funding this rate increase.

The Supplemental Budget also includes additional support for PNMI-Cs. During the pandemic, PNMI Cs have been critical to decompressing hospitals and maintaining the full range of long-term care residential beds as Maine – and the nation – have experienced staffing challenges and shifting models of care. The supplemental budget proposes a one-time, $5 million General Fund add-on payment in state fiscal year 2023 for PNMI Cs that provide a high proportion of services to MaineCare members. The payment would be made using a similar formula currently used in MaineCare for nursing facilities based on high MaineCare utilization. Facilities would be encouraged to use funds to support workforce and improve infection control practices that proved critical during the pandemic. This proposed payment would help to address immediate needs as the Department advances longer-term PNMI payment reform.

In addition to today’s actions, the Mills Administration has dedicated significant financial and technical support for nursing and residential facilities, including direct support workers, nurses, and other long-term care workers who care for older Mainers and residents with disabilities. These include:

  • In June 2019, Governor Mills signed into law a biennial budget that dedicated $28 million to nursing facilities to provide a cost-of-living adjustment and rate rebasing. As a result, nursing facility rates increased, on average, by 5 percent for Fiscal Year 2020 and another 6 percent for Fiscal Year 2021.
  • In March 2020, at the onset of the pandemic, the Mills Administration announced it would provide additional payments to nursing facilities for extra costs associated with COVID-19, including staffing above and beyond customary levels to maintain proper ratios and to monitor residents and screen visitors, supplies and PPE, such as face masks and gowns, beyond the amounts typically purchased;
  • In November 2020, the Mills Administration announced that it would reimburse nursing facilities for their costs to conduct Federally-required surveillance testing using commercial laboratories;
  • In December 2020, the Mills Administration awarded $5.1 million to health care facilities, including nursing facilities, to cover expenses resulting from the pandemic;
  • In August 2021, the Mills Administration awarded $12.5 million to nursing and residential care facilities to help them cover expenses resulting from the pandemic;

This is in addition to the considerable financial relief distributed directly by the Federal government to nursing facilities across Maine.

Further, at the onset of the pandemic, the Maine CDC hosted weekly calls for staff at long-term care facilities to provide updates on COVID-19 and on relevant guidance and to answer questions. The Maine CDC has also provided guidance and self-assessment tools for distribution to nursing facilities, and Maine was also among the first states in the nation to conduct universal testing at nursing facilities when a single case of COVID-19 was confirmed. The Mills Administration also provides emergency cache of PPE to facilities with outbreaks and provides same-day support and guidance.

The Administration’s plan to support nursing and other long-term care facilities in the short-run also complements the long-term work of the Governor’s Maine Jobs & Recovery Plan, which encourages people to pursue health care jobs in Maine and strengthens the state’s health care workforce. The Governor’s plan includes new programs that make it more affordable for Maine people to become a health care professional and makes it easier to advance in their careers once they do. It also includes a new $1.5 million recruitment effort, with $1 million dedicated to promoting the value of work in health care and encouraging young people to enter careers in health care, and the other $500,000 dedicated specifically to promoting direct care worker jobs, such as aides for older Mainers or individuals with disabilities.