The Journal Gazette
Sunday, August 22, 2021 1:00 am

Mandate worries nursing homes

Trade group says it will exacerbate staffing shortages

NIKI KELLY | The Journal Gazette

INDIANAPOLIS – Allen County nursing homes are trailing state and federal rates for vaccinating staff and residents against COVID-19.

A new mandate from President Joe Biden for employees at long-term care facilities will likely change that – though it comes with some staffing concerns.

“COVID-19 vaccination mandates for health care personnel should be applied to all health care settings. Without an across-the-board mandate for all health care settings, the nursing facility-only action will exacerbate already difficult workforce challenges,” said Zach Cattell, president of the Indiana Health Care Association and Indiana Center for Assisted Living.

“A federal mandate that applies only to nursing facilities will cause vaccine-hesitant workers to flee to other health care providers that do not have to follow a mandate and leave many facilities without adequate staff to care for residents.”

The Centers for Medicare and Medicaid Services has been tracking vaccination rates because of the toll the coronavirus has taken on nursing homes. In all, there have been 133,736 resident deaths and 2,004 staff deaths.

The national average for vaccination rates for residents was 82.8% as of Aug. 8. The rate for nursing home staffs was 60.5%.

Indiana's resident rate is 82.87%. The nursing home staff vaccination rate is 54.02% for staff – 14th worst in the nation. Allen County's homes are even lower – at 79.4% for residents and 45.6% for staff.

April Haggerty, administrator at Sage Bluff Health and Rehabilitation Center in Fort Wayne, said the staff rate of 32% isn't as bad as it seems. Because of staffing problems, the agency is using some temporary employees. Also she said it is a snapshot in time and some shifts have more vaccinated employees than others.

“It's really hard to count them on an ongoing basis,” she said. “Some are, some aren't. Some haven't provided us with documentation. It's sort of like halfway positive but not positive.”

Haggerty said staff are counted as vaccinated 14 days after the final shot so there will be an uptick soon. She also held a vaccination clinic Friday for Sage Bluff employees. 

Haggerty believes everyone in the long-term care field should get vaccinated. “If you saw the death last year I was right there in line to get it,” she said. “I don't ever want to see or go through that again.”

Cattell said numerous homes around the state have been offering financial incentives, and the vaccination rate has risen slowly.

“The numbers obviously need to improve. We support individual members moving toward a mandate. But it is juxtaposed with a critical staffing shortage. There is a real push pull here,” he said.

Some smaller homes and at least one larger network have mandated the vaccines, Cattell said, but many are waiting for the emergency use authorization to be moved to permanent status.

Biden, though, announced last week he is directing all nursing homes to require staff vaccinations against COVID-19 to continue receiving Medicare and Medicaid funding.

Virtually all Indiana nursing homes receive federal dollars.

B.J. DeCola, chief operating officer for Miller's Health Systems, said the company has used financial incentives in the form of random drawings and recognition incentives highlighting various employees and their reasons for being vaccinated.

Miller's runs about 30 nursing homes in the state.

Miller's Merry Manor in Fort Wayne has one of the state's highest resident vaccination rates – 95.6%.

“The staff has done a great job encouraging their residents and their families to be vaccinated. Most residents understand the importance and make the choice to get the vaccine,” DeCola said.

He noted that some residents cannot receive the vaccine due to a medical prohibition. And new admissions who stay less than three weeks may not have their second dose and will therefore not be fully vaccinated prior to discharge.

Currently companywide, approximately 92% of Miller's Health Systems residents have been vaccinated and 53% of staff.

“We highly encourage our staff and support them receiving the vaccination. We regularly provide education and offer links to additional information to them,” DeCola said.

He added that staffing is a major problem for employers nationwide in the industry “and will likely continue to be a challenge in the coming days with or without mandates. We feel blessed as a company to have very dedicated staff who have been with us since the beginning of the pandemic.”

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