Industry CEOs Say Vaccine Mandate Singles Out SNFs

Operators were left scratching their heads when the Biden administration “singled out” nursing home staff in its vaccine mandate, noting their residents are interacting with many more people — who don’t have such requirements — across the health care continuum.

“Our residents go all over the place… 50% of our cases in the last month, resident cases, are fully vaccinated residents and are from other settings because we had no positive staff in our building,” Carespring Health Care Management CEO Chris Chirumbolo said during a panel discussion at the Skilled Nursing News RETHINK conference.

President Joe Biden announced last month that Medicare and Medicaid-participating nursing homes had to get all staff vaccinated, or risk losing funding.

Nursing homes have been left with little direction on what to expect, but during a call with industry stakeholders late last month the Centers for Medicare & Medicaid Services (CMS) said more information on the regulation is coming later this month.

About 83.1% of residents and 61.1% of staff per facility are vaccinated, CMS reported as of the week of Aug. 15.

“We try to encourage everybody, do as best we can, but the biggest issue is if one sector is picked out like we have, that’s just unfair,” American Health Partners CEO Mike Bailey said during the panel discussion.

When the mandate was first announced they hosted town meetings at each facility to try and quell some of the staff concerns, Chirumbolo said.

A survey conducted by software firm OnShift of more than 2,100 long-term care workers found that more than 53% of unvaccinated employees plan to leave their job and find one where vaccines are not required.

He also said while staff vaccination remains a top priority, facilities still need to push resident vaccination — especially with the delta variant in the mix.

“I don’t think it’s good enough. We need to get all of our residents, as much as we can, vaccinated because they are going to other settings,” he said. “It’s going to happen independent of what we do just with the staff so we can’t just look at the staff as the main sector of the disease.”

Ignite Medical Resorts CEO and Co-Founder Tim Fields said he believes the mandate will include religious and medical exemptions, in addition to an opt out that allows staff to decline vaccination if they agree to be tested more frequently or wear additional personal protective equipment (PPE) — similarly to what some states have done.

“Of course the buildings where the leaders are really pushing it, you know, are getting better results from that but it’s going to be interesting to see how the final rule comes out and what they say,” Fields said.

And even if government officials were to extend the mandate to all health care providers, Bailey believes there would still likely be challenges.

Both finding and retaining staff is a challenge that remains at the forefront of many — if not all — nursing home operators’ minds.

Nursing home and residential care facilities have lost around 380,000 workers from February 2020, according to recent data from the U.S. Bureau of Labor Statistics.

Fields said they have recognition programs where employees can earn rewards such as discounts to their cafes or fitness memberships.

“We do everything possible to try to be the above and beyond what everybody else does in our markets to be an attractive place to work,” he said. “And then the retention piece is just how do we have a really fun and exciting culture, and a place people want to work.”

Chirumbolo said nurse training programs have allowed them to bring workers into the industry and train them on the job, which has helped staffing issues significantly in their buildings in Ohio and Kentucky.

“…Culture, retention is the number one driver because if you’re just hiring, hiring, hiring, and they’re all leaving immediately, you’re back in the same spot over and over again,” he said, adding that they have declined admissions in certain facilities if staffing levels aren’t where they need to be to care for more residents.