Nursing Homes Face Further Labor Squeeze With Mandated Vaccination

Last week Governor Ned Lamont signed an executive order requiring staff at all long-term care facilities in Connecticut to receive at least one dose of the COVID-19 vaccine before September 7. 

“We know for a fact that COVID-19 presents increased risk of severe illness and death among older adults, particularly those who have chronic conditions and compromised immune systems,” Lamont said. “Now that vaccines are widely available and scientifically proven to be safe and the most effective method for preventing hospitalization and death, it would be absolutely irresponsible for anyone working in a long-term care facility to not receive this protection that could prevent widespread infection among those who are most vulnerable from dying of this communicable disease, some of whom for medical reasons cannot be vaccinated themselves.”

Already, approximately 70 percent of nursing home staff in Connecticut are vaccinated according to the Center for Medicaid and Medicare Services. 

Although Connecticut nursing home staff rank 11th in the country for vaccination rate, that still leaves many individuals that need to receive a vaccination within the next month and poses a potentially significant additional burden on facilities that are already facing labor shortages. 

“There remains considerable staffing concerns. The staff vaccine mandate doesn’t resolve the underlying staffing shortages being experienced in nursing homes and across the Connecticut health care sector and may very well worsen the situation,” said Matt Barrett, President and CEO of the Connecticut Association of Health Care Facilities/ Connecticut Center for Assisted Living. “The staffing situation will be worsened in the event that staff are terminated for noncompliance with the mandate.”

Despite this, Barrett said Connecticut nursing homes are in full support of the executive order as the best defense against a potential third wave of COVID-19 and the spreading delta variant. 

“When implemented on a wide scale, the staff vaccine mandate will provide maximum protection for all residents, staff and others in our communities from the known and substantial risks of COVID-19,” Barrett said. “For these reasons, we believe the staff vaccine mandate should apply beyond nursing homes to cover other health care providers serving populations vulnerable to the virus, such as hospitals, assisted living communities, and home health care.”

Currently, the only health care sector without a mandate is home health care services. 

The staffing situation “will have to be monitored closely as we near the deadlines imposed in the order,” Barrett said. Currently, nursing homes are working to educate staff and provide financial incentives to vaccinated employees as a means of combating vaccine hesitancy. 

“The staffing shortage issue rises above all the concerns and the negative impact could be experienced beyond the nursing homes, such as in hospitals if nursing home admissions from hospitals were delayed or suspended because of staffing issues,” Barrett said. “Assuring for adequate hospital capacity has been a main policy goal from the beginning of the pandemic, so this is another area that needs to be watched carefully.”

Although the Governor and nursing homes would prefer 100 percent compliance with the vaccine mandate, the executive order does allow for both a medical and religious exemptions despite the fact that the Connecticut legislature removed the religious exemption for childhood vaccinations this past April.

“Federal civil rights law protects an individual’s right to cite a religious exemption. The executive order leaves the decision making and process between the employer and the employees,” explained Max Reiss, communications director for the governor’s office. “If a raft of employees start to claim a religious exemption which has never been claimed before, then it’s up to the employer to determine whether that’s sincere and legitimate, consistent with the law.”

According to Barrett it is unclear how many staff might apply for such exemptions, but individual nursing homes are currently evaluating the potential impact these could have on their policies and practices.

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