Nursing homes are struggling to meet worker immunization mandates despite the likelihood of federal sanctions.
In Pennsylvania, about 28% of the state’s 688 skilled nursing facilities had reached an 80% threshold for staff immunization rates as of Oct. 3, according to the state Department of Health. Even fewer – just 18 facilities statewide, or about 3% – said they had met the Biden administration’s goal of having 100% of facility workers vaccinated this month.
While the administration has yet to announce sanctions, many believe it could be as harsh as suspending Medicare and Medicaid reimbursements. These represent over 75% of retirement home income.
This could result in the closure of some facilities, exacerbating a labor shortage that has already prompted some facilities to suspend admissions, industry officials warn.
Public health experts, however, insist that vaccination is a must for those who work in facilities that serve the elderly and disabled nationwide.
They point to the heavy toll of covid-19 imposed on nursing home residents before the vaccines arrive. Although facilities have banned visitors and adopted strict infection control protocols in hopes of stopping further infections, experts believe asymptomatic workers unknowingly brought the virus into nursing homes before testing are readily available.
This has led authorities to target patients and nursing home staff to receive the first doses of the vaccine last winter.
As of October 3, nursing homes reported 137,678 resident deaths from covid-19 and 2,101 deaths among nursing workers.
Although many Pennsylvania nursing homes report resident vaccination rates above the national average of 85.3%, they have had a harder time persuading workers.
Nationally, vaccination rates among nursing home workers hovered just above 69% last week.
Local rates vary widely
When Gov. Tom Wolf’s administration announced goals for vaccinating Pennsylvania nursing home staff in August, officials urged family members to check the state’s website for updates. vaccination rates and to contact the nursing homes where their loved ones live in the event of a problem.
Some facilities have made progress towards achieving immunization targets.
John Dickson is President and CEO of Redstone Highlands, a Greensburg-based nonprofit that serves 1,000 elderly and disabled residents through home care, personal care and skilled nursing facilities in Greensburg, Murrysville and North Huntingdon. Redstone recently made vaccination a condition of employment. He is now close to hitting Biden’s goal.
Dickson credits Redstone’s approach to speaking to staff about their concerns, persuading most that the vaccination was necessary.
âAt the start, we had a lot of communication and conversations with the staff,â he said.
Redstone allowed medical and religious exemptions, although he only granted a handful. Dickson said many of those seeking religious exemptions were turned down when their objections were classified as philosophical rather than related to specific religions.
Over 90% of Redstone employees are vaccinated, making Redstone the leading retirement home in Westmoreland County. Dickson said a handful of employees have been suspended, pending approval of the vaccination or exemption.
Elsewhere, facilities appear to be making little progress towards staff immunization targets.
Westmoreland Manor, the 408-bed county-owned retirement home in Hempfield, has seen a barely noticeable increase in employee vaccination rates in recent weeks.
In August, the facility reported that 65% of staff had been vaccinated. According to the most recent report filed by Manor’s officials with the Centers for Disease Control and Prevention, that percentage had risen to 66.1% by the end of September.
County attorney Melissa Guiddy said the vaccination rate for staff at Westmoreland Manor was 60% on Friday. She did not respond when asked why this figure differed from what had been reported to the CDC.
In Allegheny County, the four homes in John J. Kane County – which have 1,166 licensed beds – had slightly better staff immunization rates, ranging from 77.3% to 82.2%.
Some facilities fare much worse.
At Platinum Ridge, Brackenridge’s 97-bed retirement home, formerly known as Georgian Manor, only 23.6% of staff were listed as vaccinated, according to the state Department of Health. Officials at the for-profit facility, owned by New York-based nursing home operator Prestige Health Care Group, did not respond to multiple calls for comment.
At the 589-bed Brighton Rehabilitation and Welfare Center in Beaver County, where more than 80 resident deaths from covid-19 have been reported, the staff vaccination rate has hovered at 39%.
Only two facilities in western Pennsylvania – UPMC McKeesport Longterm Care, with 18 beds, and Promedica Skilled Nursing & Rehab in Ross, with 200 beds – report that all staff have been vaccinated.
Matt Yarnell, president of SEIU HealthcarePA, which represents about 6,000 nursing home workers in 110 facilities across the state, including Westmoreland Manor and Brighton, said his members have seen the toll of the virus up close and personal personal.
âAs a union, I know at least six of our caregivers who have passed away,â Yarnell said.
He said the union had recommended that all essential workers be vaccinated.
But he said it’s important to talk to workers and address their concerns. He said some have postponed it due to lack of access and transportation to vaccination sites. Others fear losing their pay if they have to take time off to get vaccinated and fear being forced to use sick leave if they suffer from side effects.
For some, distrust of vaccines in general is a major factor in their decision not to be vaccinated.
Crystal Timko, 65, of Versailles North left her post at the Murrysville Rehabilitation and Wellness Center last year after 22 years as a certified nursing assistant, long before the vaccine was available. Fear of covid-19 has nothing to do with her decision, and she sympathizes with caregivers who refuse to be vaccinated. She decided not to do it, despite her children’s pleas, and seeing her husband tested positive.
âI don’t believe it,â she said.
Industry professional associations fear that vaccination mandates will exacerbate an already critical nursing shortage.
Zach Shamberg, president and CEO of the Pennsylvania Health Care Association, a Harrisburg-based trade association that represents more than 200 for-profit facilities, said its members say employees are wary of government, a previous infection that has left them with antibodies to the virus and concerns that the vaccine will affect their fertility – a fear experts say is unfounded – is among the main objections to vaccination warrants.
He said some facilities are not accepting new residents because they cannot staff beds.
âWe have a real problem with access to care,â Shamberg said.
He said 74% of association members who took a survey last month said they had to limit or suspend admissions in the past six months. He cited an unnamed owner in western Pennsylvania who said his nursing homes had had to turn down 80% of hospital referrals in recent weeks due to a staff shortage.
Its members say proposed regulatory changes that would increase minimum staffing levels for nursing homes in the state from 2.7 nursing hours per patient per day to 4.1 hours would further exacerbate the crisis.
Industry officials cite the Charles Morris Nursing & Rehabilitation Center in Pittsburgh, which closed this year, as an example.
The popular Squirrel Hill nonprofit operated by the Jewish Association on Aging closed last winter, citing the impact of the pandemic, low state and federal reimbursements and a growing trend in Home Care.
Christina Carden of LeadingAge PA, a group that represents operators of nonprofit nursing homes in Pennsylvania, said her group supported the federal mandate but, like Shamberg’s group, feared it would worsen nursing shortages. workforce.
âNursing facilities, in particular, face a significant challenge in more than one way to fulfill this mandate, and it is highly likely that we will see more out-of-state sales, closed doors and beds. offline in Pennsylvania as a result of expected mandates and regulatory changes for the long-term care industry, âshe said.
Even facilities that meet immunization targets struggle to maintain staffing levels.
Redstone Highlands has posted signs outside its facilities advertising $ 35 an hour for nurses, even allowing them to choose their hours.
It’s a sign of the times, apparently.
âThere is no one who does not have vacancies for registered nurses,â Dickson said.