Nursing homes worry Biden's vaccination mandate for workers could worsen staff shortages

Across the country, nursing homes are faced with a choice: mandate that staff members get vaccinated or lose funding.

President Joe Biden announced Wednesday that all nursing homes should require their staff members to be vaccinated against COVID-19 in order to continue receiving Medicare and Medicaid funding. The new mandate could take effect as soon as next month.

Some nursing home administrators are worried the decision will cause workers to head for the exits at facilities already struggling to keep employees. Others have applauded Biden's decision, calling it a way to help protect elderly nursing home residents, who are among the most vulnerable to severe effects of the virus.

Nursing homes have been at the frontlines of the outbreak since the start of the pandemic, and their workers were among the first to be eligible for the vaccine. But hundreds of thousands of nursing home workers nationwide still are not vaccinated, according to federal data. Staff vaccination rates nationwide range from 44% to 88%, according to the Centers for Medicare and Medicaid Services.

Nationwide mandate: President Biden says nursing homes must vaccinate workers against COVID-19

Many of the recent outbreaks in nursing homes, driven by the emergence of the highly contagious delta variant, areas that have low staff vaccination rates, according to CMS.

Experts warn few nursing homes can survive without Medicaid and Medicare funding, which pays for care at more than 15,000 nursing homes nationwide, according to CMS.

In Kentucky, at least 40% of nursing home workers are unvaccinated. More than 80% of nursing home residents in the state are vaccinated, compared to 50-60% of staff, according to the U.S. Centers for Disease Control and Prevention.

Kentucky Gov. Andy Beshear on Thursday said while he understands concerns about staff shortages, he supports vaccination for all nursing home workers, especially with the delta variant driving a surge in infections.

"If they are unvaccinated, the chances that they are bringing this deadly virus into the facility are so much higher," he said.

Biden's announcement caught Kentucky nursing home providers by surprise and heightened existing concerns about losing employees, said Betsy Johnson, president of the Kentucky Association of Health Care Facilities, which represents nursing homes.

She said she doesn't like that nursing homes are being singled out when hospitals, clinics, home health agencies and others that get Medicaid and Medicare funds aren't included.

Mary Lynn Spalding, CEO of Christian Care Communities, which runs 11 senior residences throughout Kentucky, worries some workers may leave their jobs and plans to step up communication and try to address concerns about the vaccine in hopes of keeping them.

"I think we can all agree there is strong evidence you should be vaccinated, but one thing we can’t do is be disrespectful of people who have chosen not to be vaccinated," she said.

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But Laura Lamb, president of Episcopal Retirement Services, which operates Episcopal Church Home in Louisville, said she was "thrilled" with Biden's announcement.

Her organization, which also provides senior services in Indiana and Ohio, recently announced it will require all employees to be vaccinated, making it one of the few nursing home providers in Kentucky to do so.

"I couldn't agree more with President Biden," Lamb said. "If you choose to work with the most vulnerable, you have to be vaccinated."

The Indiana Health Care Association and Indiana Center for Assisted Living, which represent 460 assisted living providers, said the vaccine mandate will cause some nursing home workers to leave and go to health care facilities that do not require vaccines.

The directive should apply to health care workers in every setting, the groups said.

“Without an across-the-board mandate for all health care settings, the nursing facility only action will exacerbate already difficult workforce challenges,” the groups said in a statement.

Biden's statements come off the heels of California's announcement earlier this month requiring full vaccination for health care workers by Sept. 30. That means all health care workers, not just nursing home workers, will be required to be vaccinated in the state.

About 81% of health care workers in California nursing homes across have been vaccinated. That number is far higher than the 62% vaccinated nationwide, according to CMS.

Louisiana, on the other hand, has some of the lowest vaccination rates among nursing home workers. Only around half of the people who work in Louisiana nursing homes are vaccinated, compared with almost nine out of 10 nursing home residents, according to the Louisiana Department of Health.

Local senior citizen advocates, including AARP Louisiana, have urged vaccination mandates for Louisiana nursing homes to combat the spread of the virus among the elderly.

But state officials have taken some solace that nursing home residents — who are vaccinated at more than double the rate of the general population — have not been hit as hard by this surge as they were during the previous ones.

In Ohio, 54.3% of nursing home staff have been vaccinated, according to federal data last week.

Pete Van Runkle, head of the Ohio Health Care Association, which represents the state's for-profit long-term care facilities, fears staffing shortages in the Buckeye State. A facility in Ohio on average has 19 open positions it can't fill, according to a recent Ohio Health Care Association survey. The mandate could make things worse, Van Runkle said.

"I'm scared to death of what that's going to look like," he said.

Van Runkle noted there was one large long-term care company that mandated vaccines, only to walk it back later after workers threatened to leave.

But Cincinnati-based Episcopal Retirement Services was one of the few facilities in the state to mandate the vaccine for staff. It's turned out better than what many predicted.

In fact, CEO Laura Lamb said staff members "want to work in a fully vaccinated environment because it's safer, it's safer for them, it's safer for their families. And ultimately, it's safer for the residents."

Reach Louisville Courier Journal reporter Deborah Yetter on Twitter at @d_yetter. Contact USA TODAY News Now Reporter Christine Fernando at cfernando@usatoday.com or follow her on Twitter at @christinetfern.

Contributing: Rachel Mipro, July O'Donoghue and Laura Olson, Louisiana Illuminator; Titus Wu, The Columbus Dispatch; Sarah Nelson, Indianapolis Star; Maria Sestito, Palm Springs Desert Sun; The Associated Press

This article originally appeared on USA TODAY: Nursing homes worry COVID vaccine mandate may worsen staff shortages