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The Biden administration has announced in recent weeks a series of warrants that require long-term care facilities to fully immunize staff against COVID-19, sparking mixed responses from vendors, industry leaders and advocates, including those who have said federal policies will put additional pressure on an industry that is already suffering from a labor shortage.
But some nursing homes have said they have already successfully implemented their own mandates without significantly impacting their workforce, which officials say shows how the new federal rules can be enforced to protect vulnerable elderly residents. in the midst of a new wave of coronavirus.
President Joe Biden’s tenure, announced last month, directly targets nursing homes – employees in long-term care facilities must be vaccinated for those facilities to continue to receive federal Medicare and Medicaid funding. Additional White House announcements made this week could also indirectly affect nursing homes, including an upcoming Occupational Safety and Health Administration rule that would require private companies with 100 or more employees to demand that employees are vaccinated or undergo weekly tests. Businesses that do not comply with the agency’s rule could be liable to pay fees of up to $ 14,000.
The proposed rules would also require that healthcare facilities that receive reimbursement from Medicare and Medicaid have a vaccine mandate.
Genesis HealthCare, one of the nation’s largest nursing home providers, said nearly 100% of its staff were vaccinated on August 23, with the exception of a “small number of people who benefited from ‘medical or religious exemptions,’ spokeswoman Lori Meyer told ABC News. .
“A thoughtful and encouraging dialogue, clinician-led family and peer discussions about vaccine safety and effectiveness and the impending federal mandate have all played an important role in seeing the vast majority of our employees unvaccinated. choose to get vaccinated, ”Meyer said, adding that two weeks after Genesis finished vaccinating its staff, COVID cases among residents fell by nearly 50%.
When the national campaign to immunize the most vulnerable population began in December, nursing homes were at the forefront of the long-term care industry’s battle against the pandemic, with facilities across the country. countries reporting more than 33,000 cases and 6,000 deaths per week.
In six months of effort, cases and deaths among residents of long-term care facilities fell by almost 99%, with the vast majority of residents of long-term care facilities fully immunized, published data shows by the Centers for Medicare and Medicare Services.
As of August 29, the latest weekly data available, nursing homes reported an average of 84% of residents per facility vaccinated and about 63% of staff vaccinated, according to federal data.
In recent weeks, however, COVID cases and deaths have again increased in long-term care facilities as the delta variant spreads across the country.
A recent study published by the Centers for Disease Control and Prevention found that the effectiveness of Pfizer and Moderna vaccines in nursing home residents has declined dramatically in recent months with the advent of the delta variant, from 74.7% in March to May to 53.1% in June and July.
Experts cited this data to argue for multi-pronged, multi-layered prevention strategies for nursing homes, including vaccinations of staff, residents and visitors, contractors, as well as testing. appropriate and possible booster injections.
While the overall staff vaccination rate has not increased much since Biden announced the nursing home’s mandate, more facilities are reporting higher staff vaccination rates, data shows of CMS.
As of Aug. 29, nearly 3,800 out of more than 15,200 facilities under CMS have fully immunized less than 50% of their staff, up from around 4,000 facilities the previous week, according to federal data. And the number of facilities that reported vaccinating less than 30% of their staff also declined during the week, from more than 900 the week Biden announced the warrant to 800 the following week.
Most of the facilities with the lowest vaccination rates are in Florida, Texas, Missouri, and Ohio, where vaccine hesitancy rates tend to be higher.
But more than 3,000 other facilities said they had fully immunized more than 80% of their staff, a rate almost comparable to the national immunization rate of nursing home residents, the data showed. Of these, 122 reported vaccinating 100% of their staff.
The Jewish Home Family, a New Jersey-based senior care facility in a pandemic-ravaged part of the state, is one of the nursing homes that has finished vaccinating all employees. During that process, the plant ended up laying off five of the 350 employees, CEO and President Carol Silver-Elliott said at a press conference last week.
“We felt it was a small price to pay to keep our seniors safe, and it’s something that is close to our hearts,” said Silver-Elliott. “It doesn’t take much to summon these images of the horrific experiences we’ve all had, and for all of them, they’ve suffered losses from friends, colleagues, family and elders, so I think that it also made a difference. “
Dayspring Senior Living in North Florida near the Georgia state border has implemented a vaccination mandate for all employees since January, achieving 99% compliance, said executive director Doug Adkins at ABC News.
He said one employee requested medical accommodation and another who quit rather than get the shot ended up getting the shot and returning to work. At the end of last week, Dayspring Senior Living rolled out booster shots for staff and residents approaching the eight-month mark since vaccination, Adkins said.
“Nobody likes being told what to do – it’s no different,” Adkins said, but “once the employee is vaccinated I think he appreciates that the majority of the hand -work is vaccinated and the environment is safe. “
So far, Dayspring hasn’t seen many groundbreaking cases with symptoms, Adkins added.
Despite successful efforts to vaccinate staff at his facility, Adkins said that instead of creating a mandate tied to federal funding, a better approach would have been to offer tax incentives to companies that decided on their own to put implement a vaccination mandate to help them compete and develop a workforce. which helps keep residents safe amid ongoing staff shortages.
David Totaro, director of government affairs at BAYADA Home Health Care, a multinational long-term care provider headquartered in New Jersey, told a press conference last week that the requirement to vaccinate staff could “significantly affect” the ability of nursing homes to respond to the current workforce. shortages as some nursing homes increase wages to retain employees.
The American Health Care Association and the National Center for Assisted Living, which represents more than 14,000 nursing homes, along with other local nursing home advocates, urge the Biden administration to expand vaccine requirement to all health care facilities, not just nursing homes.
“If other local health care providers and private industries do not implement immunization mandates, nursing homes are rightly concerned that unvaccinated employees may leave to work elsewhere,” the door said. word of AHCA, Beth Martino. “Otherwise, the administration will exacerbate an already severe workforce crisis in long-term care. “
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