President Joe Biden’s effort to get more healthcare workers vaccinated could devastate nursing homes and even cause some to shut down, according to state and national trade associations.
The American Health Care Association (AHCA), the National Center for Assisted Living (NCAL), and state affiliates reacted strongly to news on Wednesday that the White House will direct the Department of Health and Human Service (HHS) to craft regulations forcing nursing homes to require staffers to be vaccinated in order to qualify to receive funds from Medicare and Medicaid. The move would affect 1.3 million individuals who are employed by nursing homes across the nation receiving federal funds. According to Centers for Medicare & Medicaid Services (CMS) data, roughly 40 percent of those workers are unvaccinated.
“After seventeen months of providing tireless care at the epicenter of the COVID-19 pandemic, long-term care continues to face a troubling trend of federal and state governments threatening and punishing the same healthcare heroes they once supported and rallied behind,” President and CEO of the Pennsylvania Health Care Association Zach Shamberg said in a statement on Wednesday.
During and before the pandemic, long-term care facilities were largely understaffed and underfunded. According to a June survey conducted by the AHCA and the NCAL, ” 94 percent of Pennsylvania respondents had a staffing shortage in the month prior, on more than one occasion, where providers could not fill all of their shifts without agency staffing or asking people to work overtime or extra shifts.”
The Florida Health Care Association (FHCA) reported similar findings, showing that 92 percent of Florida nursing centers face serious workforce shortages.
“…By the Federal Government singling out nursing homes with a vaccination requirement that does not apply to health care personnel at other locations and in other health care sectors, we fear that our already critical workforce shortages will worsen,” FHCA Chief Executive Officer Emmett Reed said in a statement on Thursday.
Several state affiliates and the national AHCA/NCAL are not advocating for the freedom to choose, however. Instead, the associations argued all healthcare workers should be federally mandated to get jabbed.
“Focusing only on nursing homes will cause vaccine-hesitant workers to flee to other health care providers and leave many centers without adequate staff to care for residents,” The AHCA/NCAL said. “It will make an already difficult workforce shortage even worse. The net effect of this action will be the opposite of its intent and will affect the ability to provide quality care to our residents.”
The Oregon Health Care Association similarly argued that if vaccine-hesitant health care workers had a choice, they would work in an environment that did not mandate Chinese coronavirus vaccines.
“Singling out just nursing facilities will cause vaccine-hesitant workers to seek employment in other health care settings and patients in those settings will not be equally protected,” the affiliate argued.
AHCA/NCAL President and CEO Mark Parkinson sent a letter on Friday to Department of Health and Human Services Secretary Xavier Becerra and Chiquita Brooks-LaSure, who is the administrator for the Center for Medicare and Medicaid Services (CMS).
In the letter, Parkinson pleaded with Becerra and Brooks-LaSure to work with the associations in making a policy that would keep unvaccinated employees from leaving their jobs in droves and ultimately destroying the industry.
“We would like to work closely with your staff to ensure it is implemented in an effective way to avoid a disastrous outcome for long-term care residents,” Parkinson wrote. “Unfortunately, vaccine hesitancy among our staff is real. Failing to recognize and address that will cause hundreds of thousands of employees to abandon facilities and leave residents with limited or, in some cases, no care.”
According to Parkinson, 63 percent of staff that initially declined vaccination had varied reasons for their decision.
“Those reasons included concerns about fertility, the impact on pregnancy, as well as a general distrust of the medical community held by minority groups,” the letter reads.
After heavily campaigning about the safety and efficacy of the vaccines, staff vaccination rates reportedly rose to 62 percent, Parkinson said — though “among the remaining staff who are not vaccinated, there are some who are not persuadable.”
Parkinson officially asked the government to consider two factors when drafting a final policy:
1. If a significant portion of the approximately 38 percent of unvaccinated nursing home
staff leave, the net impact will be worse care for the residents. While the loss of just
half of the unvaccinated staff would be devastating to care, the loss of even one or
two staff in a nursing home impacts care on certain shifts and units. The plan to
implement this requirement must focus on retaining current staff. We have already
heard from multiple facilities with grave concerns about their ability to care for their
residents if this mandate is implemented in a way that drives away their staff.
2. This policy has the potential to impact women of color in a disproportionate way.
They make up a significant portion of our staff and concerns over fertility and
lingering distrust of the medical community due to issues such as the Tuskegee
experiments and experienced medical disparities have created significant levels of
hesitancy among them.
As a solution, the AHCA/NCAL officially recommended that “the president’s order should include a vaccine mandate for all health care workers in all Medicare and Medicaid certified settings.”
The associations further suggested there be a federally funded daily testing alternative for staff that will not take the vaccine.
“This will give the education efforts time to work and prevent a sudden departure of large numbers of staff,” Parkinson said, while referencing eight states (Delaware, D.C, Hawaii, Maryland, Mississippi, Oregon, Pennsylvania, and Rhode Island) who included regular testing for unvaccinated staff as a provision of their mandates for healthcare workers.
In addition to more funding, AHCA/NCAL also wants the CMA to modify its visitation guidance to allow providers to ask visitors about their vaccination status and test results and to require vaccination or negative tests prior to visits.
According to CMS, 133,736 nursing home residents and more than 2,000 staff members have died of Chinese coronavirus since the pandemic began, though Jonathan Blum, CMS’ principal deputy administrator, told CNN they have seen “tremendous progress with low Covid rates within the nursing home population.”
“We don’t want to go backwards,” Blum said, adding that they are “on a wartime footing here.”
“We are leaning in to making sure we are taking the steps that we can to ensure the health and safety of Americans and we will continue to do so,” he added. “Delta’s not waiting and so we’re not waiting.”
The news comes as states begin to take individual action, requiring healthcare workers to be vaccinated as a condition of employment. California was the first state in the nation to make such a move, and New York followed suit this week. Disgraced Gov. Andrew Cuomo (D), who is accused of hiding thousands of nursing home deaths, added that he has “strongly” urged private businesses to implement vaccinated-only admission policies — a move Mayor Bill de Blasio (D) already made in New York City.