Texas nursing homes fear Biden’s vaccine mandate could worsen staff shortages

As the increase in COVID-19 cases driven by the Texas delta crossing variant, many residences and long-term care centers have cautiously reintroduced some protocols from the height of the pandemic, such as regular testing and dedicated units for patients with COVID.

But suppliers fear a new rule could make the crisis they face even more serious.

“Everyone should get vaccinated,” said George Linial, president and CEO of LeadingAge Texas, a trade association that represents non-profit nursing homes and retirees. “But from the perspective of our members, the fear is losing staff.”

President Biden announced this week that all nursing home staff must be vaccinated against COVID-19 so that the facilities continue to receive federal funding from Medicare and Medicaid. The mandate, which will be issued by the Centers for Medicare & Medicaid Services, could be set as early as next month.

While nursing home operators say vaccines are critical to keeping residents and staff safe, they also fear the mandate could make the lack of existing staff worse. According to Centers for Disease Control and Prevention data, 57% of Texas nursing home employees were fully vaccinated as of Aug. 8, compared to 60 percent nationwide.

While staff shortages have affected the entire healthcare industry as workers struggle with exhaustion and the attraction of better-paid, short-term travel jobs, Linial said the crisis is just as severe or still worse for long-term care facilities.

In a recent survey of LeadingAge Texas members, 20% reported that they had been forced to limit revenue during the pandemic due to staff shortages. Sixty percent reported using staffing agencies to help fill vacancies, which could increase costs.

LeadingAge Texas ’220 members serve more than 30,000 residents and families, and nearly 100 members are nursing homes or assisted living facilities. LivingAge members also include providers of affordable housing, home care and hospice.

Linial said the resurgence of the pandemic only adds to the stress.

“A couple of months ago, when the cases had fallen, there was a feeling that there was some light at the end of the tunnel and that there was a certain normality that I was returning to the facilities, in terms of group activities, dining room and all that stuff. I think the staff was relieved to see how the residents were doing so much better, “he said.

As the delta variant creates a surge in cases, staff are once again in crisis mode.

“Everyone has additional guarantees, so in some ways we seem to be back to square one. It’s difficult for staff to keep up with this for a year and a half and to see some of the optimism that is receding with this delta variant,” he said. dir Linial.

Kevin Warren, president and CEO of the Texas Health Care Association, an organization that represents specialty nursing, rehabilitation and assisted living centers across the state, said he is concerned about the effects of a vaccine requirement that is only applies to residences.

“Because [the requirement]only isolated from nursing facilities, what does this do with staff who may make the decision not to stay and work in the residence and go to work elsewhere where the mandate does not exist? It’s very worrying right now if that happens, ”he said.

While the facility has been trying for months to convince unvaccinated staff through incentive programs and bonus offers, Warren said the requirement could lead to resignations rather than gunfire.

“With this mandate, especially if it stays focused only on staff who are in long-term care, although it can encourage people to say,‘ Okay, I really want to work here, so yes I will get the vaccine. “I think there’s a real fear that staff will say,‘ If I have to get the vaccine to keep working here, I’ll go somewhere else where I don’t have to, ’” he said.

Despite the concerns of providers, the healthcare industry is gradually increasing the pressure on unvaccinated workers to receive their shots. In North Texas, Baylor Scott & White, Methodist Health System, Texas Health Resources, Children’s Health and Cook Children have imposed vaccination requirements on employees.

Children's Health's flagship hospital is about 2 miles north of downtown Dallas.

Parkland has announced that in anticipation of full approval of the vaccines by the Food and Drug Administration, they will also need the shots. It was previously restricted under government executive order Greg Abbott for public entities to require the COVID feature as long as it is administered under FDA emergency use authorization.

Prior to the announcement Biden, Massachusetts and Connecticut had demanded that both nursing home employees be vaccinated against COVID-19. Genesis HealthCare, the nation’s largest nursing home company, said earlier this month that it will require features of COVID as a working condition at its 357 facilities. California, Washington state, New York and Washington, DC, have imposed warrants on all health care workers.

Warren said the mandate should be expanded “through the health continuum.” Linial favors extending the requirement to anyone who accesses a long-term care center.

“There are polls, ombudsman, visitors, so if you really want to limit the spread of COVID, I think you have to do it so that everyone who has contact with vulnerable populations needs to be vaccinated,” he said. .

Additional funding could also help eliminate the stress that many facilities feel. About 50% of LeadingAge facilities received federal payments from the Provider Relief Fund, which was authorized as part of the CARES Act, but about half of LeadingAge members who received funding said the amount they they received was not enough to cover all their costs. According to Linial, 75% of LeadingAge Texas members currently operate at a loss.

“That’s a big concern,” Linial said.

The potential loss of Medicare and Medicaid funding for facilities that do not meet the Biden requirement could be significant, said Amanda Fredriksen, associate director of state advocacy and outreach for AARP Texas.

“In Texas, almost every facility accepts Medicare beneficiaries as patients and residents,” he said.