Staffing shortages keep some KY nursing homes from mandating vaccine, survey finds
Citing a prevailing concern over staffing, some Kentucky long-term care facilities are split on whether COVID-19 vaccines should be mandated among staff, an internal survey found.
Between July 30 and August 3, the Kentucky Association of Health Care Facilities and a Kentucky Center for Assisted Living asked 283 skilled nursing centers, assisted living communities and personal care homes whether they would support a vaccine mandate at their workplace if all other health care organizations also enforced mandates. Of the 103 administrators who responded, 42% said yes, and 42% said no, according to KAHCF/KCAL. Nearly 17% said they either didn’t feel comfortable weighing in, or a vaccine mandate had already been instituted at their place of work.
The inability to maintain necessary levels of staffing in the face of a mandate was their biggest worry.
“I think we would lose the majority of our staff. We only have 46% that are vaccinated and the rest adamantly refuse,” one administrator wrote in a survey response. Only responses, not locations of responding facilities, were provided to the Herald-Leader. Another cited a high “potential to lose members, especially nurses, when there are few replacement opportunities in my area.”
Others cited rampant misinformation about the vaccine and the likelihood of mass resignations. “Younger staff have expressed overwhelming concern about the unknown long-term effects, even with massive amounts of education about the vaccine,” one administrator wrote.
“Without participation by ALL health care providers in my area, we would become a local pariah as an employer. We would have a difficult time recruiting and retaining adequate staff who would simply work at the providers who don’t require vaccinations,” another said.
Even some who agreed with a mandate acknowledged how tricky it would be to enforce while also prioritizing worker retention: “Personally, remembering the horrible losses during the pandemic, I would mandate the vaccine. However, I worry that it would cause the staffing issue to be worse.”
The administrator responses provide a glimpse into the binary dilemma many long-term care facilities face as they decide between better protecting the at-risk patients under their care by way of system-wide vaccine requirements, or risk hemorrhaging staff in an already high-stress, low-wage field.
“The concern is that there will be a mass exodus if the vaccine is mandated in long-term care settings,” said Betsy Johnson, an industry lobbyist and president of the association that conducted the survey.
Coronavirus decimated these settings in 2020, killing nearly 2,600. And while residents and staff in nursing homes were among the first groups in Kentucky given access to a vaccine, a majority of nursing home staff continue to refuse vaccination, according to the Centers for Medicare and Medicaid Services. Just over 80% of residents are fully vaccinated, compared with 49% of staff — the sixth lowest rate nationwide, just below Mississippi and above Tennessee. On more than one occasion since doses became widely available, an unvaccinated staff person has carried the virus into a Kentucky facility and infected others.
Now, as COVID-19, propelled by cases among the unvaccinated, tightens its choke hold on Kentucky — the positivity rate hit 10.46% on Friday — some health care systems are ramping up their mitigation responses. A few days after the survey closed last week, a dozen hospital systems across Kentucky announced they were requiring all staff get vaccinated. During that announcement on Thursday, Aug. 5, Kentucky’s coalition of health care organizations, including KAHCF/KCAL, called on their affiliated providers to do the same.
“We do have an expectation that every health care worker, whether that be in a long-term care facility or elsewhere, gets the vaccine,” Johnson said after her organization endorsed universal staff vaccination. But it’s not clear yet whether those calls to action have moved the mass vaccination needle in the state’s network of long-term care settings.
Similarly, while Gov. Andy Beshear called on the private sector to enforce vaccine requirements among workers, he stopped short of instituting those mandates for health care personnel at state-run health care facilities, including veterans nursing homes. After mistakenly announcing last week that such a mandate would be implemented, the governor walked it back, instead saying the state would “strongly encourage” staff at those state-operated facilities get the vaccine.
After Kentucky hospital systems and health care associations unanimously called for vaccine requirements last week, Beshear said he was rethinking whether to enact such a mandate.
“We’re going to be re-looking at the policy that we put out last week because of what we’ve seen here today,” he said Thursday.
One survey respondent said the only way a vaccine mandate would work in long-term care settings is if it’s enacted in unison statewide.
“Yes, I believe that to effectively work to keep our residents, staff and their respective families safe, this needs to be done,” they said. “[But] it, likely, is only possible if all facilities mandate at the same time.”
This story was originally published August 9, 2021 at 1:30 PM.
