Vaccinating the nation’s nursing home residents is taking longer than many have anticipated, and the family members of those in long-term care settings are certainly forgiven for being impatient: Locked away from their loved ones for months on end, residents and their families see a desperately needed light at the end of the tunnel as the shots gradually make their way into facilities across the country.
But the two-stage vaccination process will not bring immediate relief, and leaders in post-acute and long-term care have emphasized that they must take their cues from health officials when looking to reopen their doors.
In the first edition of SNN’s Vaccine Stories series, Gurwin Jewish Health & Rehabilitation CEO Stuart Almer pointed to New York rules that reset the visitation-ban clock every time a resident or staffer tests positive — a significant hurdle for a group that numbers 1,200 people.
David Mills, CEO of the nearly 70-facility North Shore Healthcare chain of skilled nursing and assisted living facilities, similarly indicated that his firm will be following the appropriate health departments’ leads when making decisions on a return to normalcy.
But he also expressed optimism that, given the progress made thus far across the Milwaukee-based chain, that that day could come soon.
“Crystal ball-wise, I would certainly hope sometime in the second quarter, we’ll be seeing a world or an environment that is going to be much improved and welcomed from families and residents, because it’s been a long road,” Mills told SNN last Thursday.
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How has the rollout been going so far?
In my mind, it’s the solution we have been hoping and asking for — for the better part of a year. I see this as a significant light at the end of the tunnel, and we’re 100% behind it. It’s a monumental effort by a lot of people — our pharmacy partners, certainly our staff — over the next couple of months.
Thus far, we have had about 15 clinics that have been completed. We have 58 skilled nursing homes and 11 assisted living [facilities]. It’s a really, really busy time right now in all of our centers to coordinate the applications, the billing, working with our pharmacy partners and scheduling the timing. It doesn’t come without a lot of effort, but we are 100% focused on getting as high a level of compliance as we can with getting people vaccinated.
So, thus far, I think it’s gone very well. I think we learn with each one on being prepared and making sure we’re being as efficient as we can. But I’ve been very happy with the coordination and cooperation with CVS and Walgreens. So far, I think we’re on track.
I think a real challenge for all providers, at least from what I’m hearing, is education and doing everything that we can to have as high a level of participation as possible. We’re seeing a very high participation rate with our residents. But we need to continue to double down and really reinforce our expectations, lead by example, and do everything that we can as organizations and leaders to get as many of our staff members vaccinated as possible.
That’s a big challenge. We’re working very hard at it. Quite honestly, I think that’s something that is going to need to continue to hopefully improve, and we’ll see better and better results along that line with our staff.
What percentage of your staff have been opting in so far, and where would you like to be in terms of percentage?
I rely on the experts when I talk about herd immunity, and what that means and what it takes — and that’s something significantly north of 50% for staff.
That is kind of the range that we’re in; it’s in that 50% to 60% range right now. Not only within the organization, but also across the industry, whatever we can do to share best practices, educate, lead by example — we have really got to double down on increasing participation there.
We are not making it mandatory currently. I know there’s fear and there’s anxiety and uncertainty, but we really view this as a big part of the solution, and the only way we get there is to get people on board with getting the vaccine.
What have North Shore’s advocacy and awareness programs looked like?
Very, very high visibility. We had a very compelling video put together by our chief clinical officer, Tina Belongia. We have posters. We have done different flyers with educational information. We’re setting up a town hall; we’re engaging our medical directors to help from a medical professional perspective, giving their advice and opinions and being accessible.
Our pharmacists — we’ve had not only our pharmacy partners, but the group that leads our medical directors on a few calls, just really brainstorming: What can we do to solicit our medical professionals to dispel the myths, to gain trust, to answer questions? Hopefully, with them hearing from the people in the field that are experts, it will turn the tide for those that have questions and concerns and can get them in a place where they’re comfortable.
It’s something we talk about every day. We’re measuring it every day. Where we’re finding that we don’t have the compliance that we hope or we need, we’re having direct follow-up to see the why, and learn from it — and hopefully get more people on board.
So you’re working with both Walgreens and CVS?
The great majority of our centers so far have been CVS. I think there’s been one or two that have been Walgreens.
I mentioned “lead by example.” We have our senior team that we’ve deemed as essential workers, because they’re in buildings and doing what they need to be doing in our centers. I think it’s critically important that they see us on that front line, saying: “We’re doing this.”
I bring that up [because] where I had the opportunity to get mine, we had CVS there. I thought they did a very, very good job — a large number of staff, very coordinated. I was very impressed with their service.
How do you see the vaccination effort prompting policy changes around visitation and group activities?
The most important thing is we’re going to follow the guidance of local and state public health [officials], and they will decide — with our feedback, of course — what and when that’s going to occur.
I personally see this as a big part of the solution. As we turn the corner, and we see less infections, staff back to work, and really what I would call the new normal — I would like to believe in a relatively short period of time, we’re going to be able to get back to the things that our residents and family members have been missing the most, and that’s the issue around social isolation and lack of visitation and touch and personal care.
Ultimately, it will be the state and local public health [departments] that will guide us with that, but when the vaccine does what I believe it’s going to do, I would think in very short order thereafter, we’ll be able to get back to those kinds of things that have been the most frustrating for staff and residents and families.
Crystal ball-wise, I would certainly hope sometime in the second quarter, we’ll be seeing a world or an environment that is going to be much improved and welcomed from families and residents, because it’s been a long road.
Speaking of family members, are they generally more open to their loved ones receiving the vaccines, and providing the proper consent if necessary?
In a broad sense, the short answer is yes. For the most part, [they’re] very supportive, very engaged, appreciative. It’s not 100%, but the level of participation, and desire to be vaccinated on the resident side, supported by families — those numbers are much higher.
This interview has been condensed and edited for clarity.