Nursing home advocate concerned as vaccination deadline for staff looms – Joplin Globe

Officials with nursing homes in Missouri, as well the rest of the country, are facing losing employees because of a deadline for health care workers to have received a COVID-19 vaccination at the same time resistance to the vaccine is hardening and the coronavirus is spiking.

The federal Centers for Medicare and Medicaid Services issued guidance Jan. 14 that said workers in all facilities that receive Medicare or Medicaid money must have received at least the first vaccine shot by Feb. 14 and have received both shots of a two-shot vaccine by March 14.

These guidelines came out after a U.S. Supreme Court ruling Jan. 10 that upheld the government’s authority to require health care workers to be vaccinated. At the same time, the court rejected the argument that the government could require all workers in larger businesses outside of health care to be vaccinated.

Nikki Strong, executive director of the Missouri Health Care Association, which represents long-term care facilities, residential care facilities and assisted living centers, said both sides of the Supreme Court decision create challenges for nursing homes.

“With the OSHA rule being thrown out, now we’re competing with every other entity,” Strong said. “There’s no level playing field from a staffing perspective for nursing homes or other health care entities to be able to comply when our workers can simply leave and make as much money or more somewhere else with maybe an easier job.

“Workers are saying, ‘It’s none of your business why I don’t want to take the jab. I will go to work at the gas station and make as much money. And that’s an easier job.’ Working at a nursing home is tough; it’s tough work. The folks we care for are very vulnerable, they’re very sick, they have high care needs. This is not an easy job.”

Last month, Mark Parkinson, president and CEO of the American Health Care Association and the National Center for Assisted Living, representing more than 14,000 nursing homes and long-term care facilities across the country, said in a statement that “we are deeply concerned that the current mandate issued by CMS will cause nursing homes to lose staff at a time when we are already grappling with a historic labor crisis. We continue to urge CMS to allow a regular testing option for unvaccinated staff and, therefore, support any legal remedy or CMS action that would bring about this solution.”

According to AARP, nearly 160,000 nursing home residents have died of COVID-19, including 1 in 45 nursing home residents in a four-week window between early December 2020 and early January 2021, when around 24,000 residents died. Even though 87% of nursing home residents are vaccinated, many are immunocompromised with chronic health conditions, AARP noted.

In a letter last month to Chiquita Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services, AARP officials wrote: “In particular, requiring Medicare and Medicaid facilities to ensure the vaccination of their staff is an important step to protect the health and safety of those working in, and those seeking treatment or care at, Medicare and Medicaid facilities, especially nursing homes. Residents and staff in nursing homes and other long-term care facilities have experienced unconscionable devastation with over 186,000 deaths due to COVID-19, an extremely high number, given that nursing home residents comprise less than 1% of the U.S. population. This is a national disgrace and must never happen again.”

The numbers

Strong said the next two months could be bleak times as workers face a choice of either getting a vaccine some don’t trust or seeking jobs outside the health care field, and nursing homes face the challenge of replacing the workers who decide to leave with enough new employees to take care of their residents.

“If you look at our numbers, our staff percentages of people who have been vaccinated are higher than the general population, which is good, but the vaccine hesitancy among nursing home staff is significant,” Strong said. “You couple that with the problems with staffing everywhere you look. Whether it’s a fast-food restaurant, a gas station, everywhere you look there are job openings. And what our staff are saying is, ‘We don’t believe in this vaccine,’ for whatever reason. Maybe they have a religious exemption. Some have a health care reason. Others are flat-out saying, ‘The government can’t tell me what to do with my body.’

“We’ve done everything we can to educate, but the vaccine hesitancy is so high in this state that they’re saying, ‘We’ll go find another job in another industry that doesn’t require us to vaccinate because we don’t believe in the vaccine.’”

According to the website data.cms.gov, which tracks COVID-19 statistics regarding nursing homes, Missouri ranks behind all 49 other states as well as the District of Columbia, Puerto Rico and Guam in percentage of health care workers who have been vaccinated.

The website says 67.3% of workers in facilities that have reported their vaccine data are vaccinated, while many states are over 90% and some, like Rhode Island, are approaching 100%. According to the website, about 87% of nursing home residents in Missouri are vaccinated.

The vaccination rate among the public in Missouri is 54.47%, which ranks 41st among the states.

The Feb. 14 and March 14 deadlines apply to 24 states that were covered by an injunction by a lower federal court preventing the government from enforcing its vaccine mandate.

“I think right now facilities are just scrambling,” Strong said. “With the injunction in place they were continuing to educate and continuing to encourage workers to take the vaccine. Now I think there are people, who are resistant but don’t want to leave their jobs, who will have to sit back and make a conscious decision whether or not they will agree to take the vaccine and keep their job or not.

“I’m very fearful; I think we will have some facilities that are put in a really tough situation and we’ll just have to see how all this plays out over the next couple of weeks. But it’s not good news for us, and even as the omicron variant has played out, people realize that it has been less severe, it adds to the vaccine hesitancy.”

Local nursing homes

Jennifer Knecht, spokesperson for Christian Horizons Living Centers, which owns the Spring River Christian Village in Joplin, said 100% of the workers at that center are vaccinated or have been granted a waiver because Christian Horizons acted in April 2021 and set a deadline of Nov. 15, 2021, for workers to be vaccinated against COVID-19 and the flu as a condition of employment.

“We made the decision, and we gave plenty of time to all of our associates,” Knecht said. “We let them know that our deadline for compliance was Nov. 15, so we navigated through that. We knew we were going to lose some very valued associates based on their personal decisions, and certainly we did lose some valued associates, and that’s always very tough. But we felt that was the long-term decision that needed to be made.”

Knecht said Christian Horizons felt the impact of the competitive labor market and acted aggressively.

“We definitely felt the impact of all the outside industry forces that have been in play,” Knecht said “We have gone through a couple of waves of wage increases — part of those we were discussing before COVID but we had not put them fully into effect. I can’t give you super specifics, but we did a pretty impactful increase across all of our communities at Christian Horizons.”

Joe Perkins, spokesperson for Northport Health Services, which owns the Joplin, Carthage and Webb City Health and Rehabilitation Services centers, said he didn’t have all the numbers at print time, but only one health care worker at Joplin Health and Rehabilitation has not been vaccinated or received a religious or medical waiver, and that number ranged up to 10 at the company’s other facilities in Missouri.

“We are on a protocol where we test every single employee at the beginning of every shift, so if someone tests positive they’re sent home,” Perkins said. “We’ve been pushing so hard to get our people vaccinated, and there may be other nursing homes that are not in as good a shape as ours, and they’re going to face, on that deadline, a horrible situation. People are going to have to go home, and the administration is going to have to figure out how to take care of the people in the buildings.”

Perkins said Northport has spent hundreds of thousands of dollars recruiting and paying workers to stay with the company.

“We’ve had some pretty aggressive programs going in Missouri so we’re recruiting extremely heavily,” Perkins said. “We have paid bonuses, we’re paying signing bonuses, we’re paying re-up bonuses, we’re hiring traveling nurses. We attacked it very aggressively and used money.”