Staff vaccination rates in some nursing homes cause concern about federal mandate and outbreaks – Monadnock Ledger Transcript

As the number of long-term care outbreaks have topped 20 in New Hampshire and a federal vaccine deadline approaches, some facilities are still struggling to raise vaccination rates, according to data from the Centers for Medicaid and Medicare.

Last week, the N.H. Department of Health announced that 21 nursing homes, rehabilitating centers and assisted living facilities are in the midst of a COVID-19 outbreak. This round of outbreaks has infected 365 residents and killed 16.

New Hampshire’s staff vaccination is still well above the national average, 72.8%. Still, 10 long-term care facilities have less than 75% of their staff vaccinated, including Pleasant View Center in Concord.

Steven Woods, who recently stepped in as Pleasant View’s administrator, said he doesn’t know why his facility’s vaccination rate, 73%, is lower than that of most other facilities in New Hampshire.

He said he is meeting personally with staff to encourage vaccinations and setting up one-on-one clinics for those interested in the shot. Woods said he doesn’t know how many plan to sign up and how many plan to leave their job as a result of the federal vaccine mandate.

Pleasant View is simultaneously handling an outbreak that infected 11 residents and 10 staff members. Woods said the cases are on the decline.

Staff vaccination rates in long-term care facilities are still slightly lower than that of the residents they serve. While about 93% of long-term care facility residents in New Hampshire are vaccinated, 88% of staff are vaccinated.

Staff vaccination is especially crucial as immunity from the initial series of shots wanes in older adults. Two studies put out by the Centers for Disease Control and Prevention found that the vaccine is becoming less effective at reducing hospitalizations for those older than 75. This decline in efficacy is partly due to the highly contagious delta variant.

Though vaccinated people can still have the potential to spread COVID-19 to others, the risk is much lower than in unvaccinated people, according to the CDC.

The federal government imposed a vaccine mandate for employees of healthcare facilities that rely on Medicare and Medicaid dollars in an attempt to protect some of the countries most vulnerable residents. Employees of about 70 facilities statewide will be required to be fully vaccinated by Jan. 4, the Biden Administration announced last week.

Staff vaccination rates not only represent how protected they are against COVID-19 but also how many staff members they could stand to lose once the mandate deadline arrives.

Hillsborough County Nursing Home has a staff vaccination rate, 86%, on par with the state’s average. Even so, David Ross, the facility’s administrator, said the federal mandate could cause the home to lose 45 employees.

“I am not in a position to lose even five people, and the risk of losing 40 is quite impactful,” he said.

Ross won’t know how many staff are leaving until a couple of days before the mandate is imposed. Some staff have decided to seek a medical exemption from their doctors which may or may not be approved. Others have signed up for a clinic appointment but could cancel at the last moment, as Ross has seen happen many times over the past several times.

“This week has been really challenging,” he said. “There’s a lot of angst here: folks are reeling from it.”

The effect of losing 15% of his staff could be “catastrophic,” he said. If all of the unvaccinated employees leave, he said the facility will seriously have to consider ceasing new admissions and consolidating their current residents.