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Local nursing homes deal with vaccine mandate

Requirement puts pinch on facilities already struggling with staffing woes

Blair County nursing homes are struggling with the federal mandate that all employees be vaccinated against COVID-19 by Jan. 4 unless workers obtain medical or religious exemptions.

Managers fear the mandate will aggravate existing worker shortages.

It’s a reflection of a national problem.

The “overall intent” of the vaccination mandate, which is being enforced through the Centers for Medicare and Medicaid Services, is good, but the nursing home community is “concerned that the execution will exacerbate an already dire workforce crisis,” American Health Care Association/NCAL CEO Mark Parkinson stated in a news release. “Even a small percentage of staff members leaving their jobs due to this mandate would have a disastrous impact on vulnerable seniors,” Parkinson stated.

Nationally, nursing homes have lost more than 380,000 workers because of COVID-19, and “reports indicate that the staffing shortages show no signs of slowing,” stated the AHCA.

The labor shortage has led to 58 percent of nursing homes placing limits on new admissions, according to the AHCA.

Higher pay, better shifts and more flexible scheduling would help reverse the losses, according to the AHCA.

Garvey Manor

Garvey Manor in Hollidaysburg is running “a decreased census” of about 80 percent capacity because it lacks a full complement of employees. That and having 22 percent of its workforce not fully vaccinated creates concern, according to Administrator Sister Joachim Ferenchak and the state Department of Health website.

While the home is compliant with DoH staffing regulations and is even taking some admissions, it’s also continuing a nearly yearlong effort to persuade employees to be vaccinated, Ferenchak said.

That has included vaccination clinics at the facility and an initial in-house vaccination mandate that the home rescinded after the federal mandate came out, she said.

“We don’t want to lose any staff over this,” Ferenchak said.

But it can be hard “to convince people of the absolute need,” she said.

Recent COVID-19 numbers in Blair County attest to that need, she stated.

“We’re not controlling (the spread),” Ferenchak said.

People “have feelings” about vaccinations and want the right to choose, Ferenchak said.

But many have absorbed “false information,” lots of it from social media, including “some very bizarre ideations,” she said.

Garvey has been following CMS requirements in verifying the validity of medical exemption requests, said Ferenchak, when asked about a certified nursing assistant’s dismay at what she considers intrusive demands for personal medical information to justify her exemption request.

The CNA is not an anti-vaxxer, but has had multiple serious allergic reactions to prior vaccinations, and her doctor has advised her not to get the COVID-19 shot. She asked that her name not be used for fear of repercussions.

“It’s not Garvey Manor” that has determined the detailed nature of the information required for medical exemptions, Ferenchak said.

“I can see Garvey’s point of view,” the CNA stated.

But she feels mistreated, not only because of the medical information demands, but because of additional restrictions that may be imposed on her at the home if she doesn’t get vaccinated, she said.

Garvey has open positions, mainly for nursing assistants and dietary workers.

The home has held job fairs, but they weren’t well-attended, the CNA said.

“I think every home is experiencing the same circumstances,” Ferenchak said.

Things won’t improve much until communities “get better control” of COVID. “I wouldn’t say it’s frustrating,” she said. “(But) it’s intense.”

The Village

at Morrisons Cove

The Village at Morrisons Cove has been “challenged” by the “additional regulations and restrictions,” according to Dawn McCartney, vice president of marketing and program development.

“Facilities are experiencing nursing and support staff leaving the industry at an alarming rate,” McCartney wrote in an email. “The recent unveiling of the OSHA and CMS requirements for all health care staff to be vaccinated on top of an already struggling workforce just adds another blow.”

It hasn’t helped that nursing homes have had to resort to staffing agencies, which charge a premium, McCartney wrote.

Meanwhile, reimbursements for patient care from Medicare and Medicaid are “minimal,” McCartney stated.

In contrast to non-health care companies covered by a different vaccination mandate that will be enforced by the Occupational Health and Safety Administration, health care organizations won’t be able to use frequent COVID-19 testing as an alternative to vaccination, McCartney noted.

That will only contribute to “a mass exodus from the industry and cause facilities even more hardships as they struggle to keep our precious residents safe,” McCartney wrote.

Moreover, “(t)he timeline for this mandate is also within two months, which gives facilities little to no time to put a reasonable and attainable plan in place,” McCartney wrote.

The real problem with the situation is “the impact this has had on (residents’) everyday lives,” McCartney wrote.

“Many do not understand the details about this virus or the destruction it is causing,” she wrote. “Many long to see their friends and families on a regular basis because in order to keep them protected from contracting the virus, nursing homes are often closed down to visitation during outbreak periods.”

Presbyterian Village at Hollidaysburg

One nursing home group that doesn’t seem to be struggling as much with the mandate is Presbyterian Senior Living, which has a facility in Hollidaysburg.

It’s doing better because it anticipated the federal order, according to information provided by PSL spokeswoman Kristin Hambleton.

“PSL got in front of this back in May,” Hambleton said in a phone interview.

At that time, the Dillsburg-based organization made vaccination against COVID-19 a condition of employment, setting an Aug. 31 deadline for employees to be fully vaccinated.

“We’re in the business of serving the most vulnerable population,” and one way to fulfill the responsibility that implied was to enact the requirement early, she said.

“I truly believe that we as an organization had the moral responsibility to take (such) action,” said Presbyterian Hollidaysburg Executive Director Jeremy Schrader.

It seemed like “it was going to go in that direction” anyway, Schrader said.

“The vaccine saves lives,” Hambleton stated.

After enacting the requirement, the organization held vaccination clinics “early and often,” Hambleton said.

The organization expected pushback from workers, and got it, she said.

Managers in all the homes responded by working with those who had concerns, talking through the issues, trying to dispel “myths” and provide reassurance, she said.

Management at Hollidaysburg “took this seriously and embraced it,” she said.

The “education” at Hollidaysburg included counseling by doctors, Schrader said.

PSL expected to lose employees as a result of the requirement, but had “plans in place to deal with that reality,” Hambleton said.

The Hollidaysburg home lost nine workers — “not a bad number,” Schrader said.

Two employees obtained medical exemptions, Schrader said.

Presbyterian at Hollidaysburg is currently accepting admissions and has a good census level, Hambleton said.

There are still staffing issues, and the home in Hollidaysburg could use additional workers to boost the census, according to Schrader.

But that is a continuation of pre-pandemic conditions, they both said.

“It seems like everybody is looking,” Schrader said. “No matter what industry.”

Hollidaysburg Veterans Home

As with the Presbyterian Home, the Hollidaysburg Veterans Home tightened its requirements ahead of the federal mandate, according to state Department of Military and Veterans Affairs spokeswoman Joan Nissley.

Since September, based on a mandate from Gov. Tom Wolf’s administration, the home has required unvaccinated employees to undergo twice-weekly testing and to use N-95 masks and face shields at all times in the facility, Nissley wrote in an email.

Management “routinely engages with staff to encourage and educate them on the benefits of vaccination,” she said.

The home hasn’t had to reduce its census due to staffing issues, although it is looking to fill vacant positions, Nissley said.

The home has been in compliance with regulations that set staff-to-patient levels. “We have been fortunate to not see any significant health care worker loss,” Nissley said.

The Lutheran Home at Hollidaysburg

Staffing levels at the Lutheran Home at Hollidaysburg exceeds state requirements, according to Allegheny Lutheran Social Ministries spokeswoman Andrea Schurr.

Mirror Staff Writer William Kibler is at 814-949-7038.

By the numbers

State Department of Health website statistics on Blair County’s nursing homes:

Altoona Center for Nursing Care: Fully vaccinated: 71% residents, 68% staff; 83 beds occupied on average; COVID-19 cases: 85 residents, 104 staff; deaths: 17 residents, no staff.

Hillview Healthcare and Rehabilitation Center: Fully vaccinated: 91% residents, 69% staff; 77 beds; COVID-19 cases: 91 residents, 57 staff; deaths: 41 residents, no staff.

Maybrook Hills Rehabilitation and Healthcare Center: Fully vaccinated: 82% residents, 51% staff; 185 beds; COVID-19 cases: 48 residents, 93 staff; deaths 5 resident deaths; no staff.

Garvey Manor: Fully vaccinated: 95% residents, 78% staff; 117 beds; COVID-19 cases: 68 residents, 88 staff; deaths: 15 residents. No staff.

Hollidaysburg Veterans Home: Fully vaccinated: 91% residents, 52% staff; 144 beds; COVID-19 cases: 69 residents, 207 staff; deaths: 21 residents, no staff.

Lutheran Home at Hollidaysburg: Fully vaccinated: 89% resident, 51% staff (12 percent of staff partially vaccinated); 60 beds; COVID-19 cases: 64 residents, 92 staff; deaths: 30 residents, no staff.

Presbyterian Home in Hollidaysburg: Fully vaccinated: 98% residents, 100% staff; 64 beds; COVID-19 cases: 58 residents, 79 staff; deaths: 20 residents (13, according to Presbyterian Senior Living spokeswoman Kristin Hambleton), staff deaths not displayed.

Homewood at Martinsburg: Fully vaccinated: 97% residents, 64% staff; 100 beds; COVID-19 cases: 48 residents, 106 staff; deaths: 9 residents, no staff.

Morrisons Cove Home: Fully vaccinated: 84% residents, 55% staff; 103 beds; COVID-19 cases: 56 residents, 15 staff; deaths: 7 residents; no staff.

Epworth Healthcare and Rehabilitation Center: Fully vaccinated: 77% residents, 46% staff; 78 beds; COVID cases: 69 residents, 54 staff; deaths: 24 residents, no staff.

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