With vaccination rates lagging among staff, nursing homes worry about staffing and lockdowns

Sep. 23—The ongoing shortage of nursing home workers — from nurses to housekeepers to food service workers — is pinching nursing homes in new ways, as homes also deal with persistently low vaccination rates among the staff who work with their vulnerable residents.

A temporary employee at Sullivan County's nursing home tested positive for COVID-19 last week, causing the home to lock down one of its units. And Grafton County Nursing Home is suspending new admissions of residents until there is more clarity around a federal requirement for nursing home staff to be vaccinated, and the effect that mandate will have on staffing.

Sullivan County Health Care tests staff for COVID-19 twice a week; administrator Ted Purdy said one of those tests turned up a positive case. The unit where that person worked was locked down, Purdy said, and the home has twice tested all residents and staff who had been on the unit. No one else has tested positive, Purdy said.

Until vaccination rates go up, Purdy said he thinks the twice-weekly tests and semi-regular lockdowns are a new normal for nursing homes.

"The higher the vaccination rate, the less likely we're going to have issues in the community," Purdy said. "But until we meet the required 'herd immunity,' this is going to become routine."

Nursing home workers will be subject to a federal vaccination requirement, but the rule has not been issued by the Centers for Medicare and Medicaid Services.

Nearly all residents of nursing homes are vaccinated — in the Sullivan County home, 95% of residents are fully vaccinated — but staff vaccination rates lag, as they have all year. Right now, Purdy said, just over three-quarters of his staff is fully vaccinated against COVID-19, though he said that figure will rise with several staffers' second-dose appointments scheduled.

Temporary staff, and those who work for nurse staffing agencies, will likely be required to be vaccinated, the same as permanent nursing home staff, Purdy said. That will be important, he said, because Sullivan County relies on temporary and per diem staff to work with its residents amid a shortage of staff.

The Sullivan County home is about 70% full, and does have the staff to take in new residents.

Pause in Grafton County

Grafton County Nursing Home is at 77% capacity, administrator Craig Labore reports.

Labore said right now, he does have the staff to handle more residents, but he worries about how long those workers will stick around, especially after the vaccine mandate takes effect.

Worried the coming federal vaccination requirement will push unvaccinated staff to resign, the Grafton County Nursing Home has suspended new admissions. Just under a quarter of the staff at the Grafton County Nursing Home in North Haverhill are unvaccinated, Labore said. He worries they might resign rather than take COVID-19 vaccines. So the home is pausing new admissions to head off a situation of having more residents than staff can reasonably care for.

"It's about making sure we have the staff to meet the needs of the residents we have living with us," Labore said.

Staffing has been a challenge for years as long-serving staffers retire, and people are not coming in to replace them.

Labore said the primary issue is the low pay. Because nursing home workers' pay is essentially fixed by the state Medicaid reimbursement rate, he is not able to compete with other local employers. That reimbursement rate is among the lowest in the country.

He doesn't blame the workers, Labore said.

"Especially as the cost of living is going up," he said. "That $7 an hour means a lot."

He worries that for some of the remaining staff, the vaccine requirement might push them to find other jobs.

Purdy, though, is eager for the release of the vaccine requirement rule, because he hopes it will mean higher vaccination rates, and fewer lockdowns for residents.

"Personally, I look forward to that," he said.

jgrove@unionleader.com

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