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Executive Summary

               Meeting the Demand for Long-Term Care Facilities in Maine

This study reviews the existing 2023 Maine Long-Term Health Care (LTC) Licensed Facilities and forecasts their demand for the year 2033 by Location, and Facility Type. The studies Facility Types are: Assisted Living Program Facility (ALP), Nursing Homes (NursH), and Residential Care Facility (RCF) and RCF Private Non-Medical Institutions (RCF PNMI).

The goal of this study is to present the order of magnitude numbers and inform; Government, LTC facility owners and operators, educators, and other affected parties of the locational demand for Long-Term Care facilities in the State of Maine. A summary of expected costs and personnel requirements is provided, and a look at Maine’s 65+ age cohorts’ challenging effect on its economic future. Suggested initiatives to support the expansion and sustainability of Maine’s (LTC) Facilities are outlined.

Looking at the data, Maine is facing a burgeoning 65+ demographic and locational challenge in LTC facilities. This study reveals that the current LTC facility and personnel commitment or corresponding home health care bed capacity and locations needs to be expanded to meet this challenge.


Inventory Statistics

In late 2023 Maine had 2284 ALP beds, 3520 RCF beds, 4064 RCF PNMI beds and 6124 NursH beds for a total of 15992 beds.

There are (late 2023) 1208 Long Term Care Facilities. There are 838 RCF, 216 RCF PNMI, 70 ALP and 84 NursH Facilities.

The 2023 availability of Facilities and beds is uneven across the State. Androscoggin and Cumberland Counties have 76 beds per 65+ 1000 population while Waldo County has 18 beds per 65+ 1000 population. The ME average is approx. 53 beds per 65+ 1000 population. Aroostook and Washington Countys have no ALP facilities.


Demographic Demand

The 2022 to 2033 increase in Maine of 94,000 in the 65+ population is a result of the “WW II Baby Boom”. This cohort group are those born between 1946 and 1964 (those 58 to 76 years old in 2022). It should be noted that Maine has a large 50 to 54 cohort group, indicating an extension in Maine births. The ME 65+ Population in 2022 was estimated at 302,000 with a 2033 population estimated at 396,000

In 2022 the States Dependency Ratio was 68, consisting of 30 for years 1-18 and 38 for 65+Pop meaning 68 people are dependent on 100 age 19-64.

State Demographics by County –


Maine’s Census Tract Data is a key factor when analyzing 65+ demand geography. This map indicates the census tract data from the 2022 American Consumer Survey ACS

Maine’s 65+ Pop constitutes 22% in 2023 and 28% in 2033 of the States Total Pop.


As of 2033 % of their counties total Pop, Oxford County is max. at 37% and Hancock County is a minimum of 23%.

Population Shift


If existing demographic trends continue, Maine’s population will DECREASE approximately 200,000 by 2052 (30 years). This reduction will begin in approx. 2030 when the first Baby Boomers reach the average mortality age of 82. This reduction in population will present a challenge to the state’s economic stability.

Forecast Beds and Facilities

The forecast indicates the need for 8700 Total additional beds in existing and 12 new locations by 2033. The forecast utilizes a state top-down and county bottom-up forecasting process of the facility type, and bed counts equating to approx. 870 beds per year, providing a 2033 total in-service of 24,700 beds.


Determining the community locations that need new facilities. (Indicated in yellow on maps) utilizing GIS and drive times around existing and new facilities to provide state service coverage as indicated in the maps below.

Supporting Services in the ecosystem for those over 65. Analysis reveals the need for additional Hospice and Dialysis Serving areas. Hospitals are well distributed around the state’s population centers and one key to future LTC facility locations.




Mental Illness/Dementia/Alzheimer’s

The Mental Illness and Dementia/Alzheimer’s facilities are uneven across the state. New ALP construction of these specific service facilities is needed geographically spread throughout the state.


New Facility Cost

The capital cost to build the new facilities (Building, machinery and equipment) is estimated at $3 Billion from 2024-2033.


Operating Cost

The additional beds operating cost is estimated to be $820 Million over the 2024-2033 period.


Additional Staff

An additional 3800 LTC Staff members will be required 2024 -2033, consisting of 2070 Admin Staff, 1730 Nursing Staff.


Select to see full 53-page study as a PDF.