This undervalued status translates into noncompetitive compensation and benefits for all staff categories in the clinical and managerial arenas. Within the field there exists a hierarchy in which individuals working in hospitals receive higher compensation and better benefits than those working in nursing home care or homecare. Compared with registered nurses who work in hospital settings, registered nurses working in nursing homes or other extended-care facilities receive lower annual earnings on average, even though they work more hours per week, incur more hours of overtime, and have a larger percentage of overtime hours that are mandatory (Bureau of Health Professions, 2006). In 2007, Forbes Magazine profiled personal and home care aide jobs as one of the top twenty-five worst-paying occupations in America (Maidment, 2007). Stakeholders in some states have observed that acute-care hospitals are able to draw staff away from long-term-care employers by offering higher salaries and better benefits (Center for Health Workforce Studies, 2006). As well, aging services providers have a diminished capacity to increase wages because more than 70 percent of their financing comes from Medicaid and Medicare, which seek to limit costs regardless of labor market conditions.