Upper Valley nursing homes worry federal COVID-19 vaccination mandate could drive workers away

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    Hanover Terrace Health and Rehabilitation Center Administrator Martha Ilsley, left, talks with a resident of the Hanover, N.H., nursing home in 2016. Hanover Terrace has had no COVID-19 cases, and Ilsley says "everybody's wearing many hats right now" to care for residents. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Jennifer Hauck

Valley News Staff Writer
Published: 8/24/2021 9:48:16 PM
Modified: 8/24/2021 9:48:16 PM

HANOVER — Though most of the workers at Hanover Terrace Health and Rehabilitation Center on Lyme Road are vaccinated against COVID-19, the facility’s administrator said she worries that the other 27% may opt to find other employment when a federal vaccine mandate for nursing home workers that the Biden administration announced last week goes into effect.

If the 100-bed facility loses more than a quarter of its workforce, it will face “a severe staffing challenge,” said Martha Ilsley, Hanover Terrace’s administrator, who added that fewer staffers would also mean fewer beds for people who need nursing home care.

“Since Medicaid rates are low, compounded with not being able to admit (new patients) if we don’t have the staffing, financially it would be hard to sustain this for a period of time,” Ilsley said of a potential drop in staffing. “I have been an administrator for years, and I don’t remember when in my career there has been a more difficult time than now for nursing facilities.”

Ilsley and other Upper Valley nursing home administrators said they feel that the planned nationwide vaccination mandate for nursing home workers, which the Centers for Medicare & Medicaid Services announced earlier this month, targets them and allows room for workers to find employment at places that aren’t requiring the shots. Some nursing home officials are seeking additional financial support to weather these challenges.

“It’s not a level playing field,” said Brendan Williams, president of the New Hampshire Health Care Association, which represents the state’s nursing homes.

Nursing homes are at risk of losing staff to some hospitals, home health agencies and community health clinics that also receive federal funding but are not yet requiring the shots, Williams said.

“President Biden’s mandate seems to be singling out nursing homes only with the mandate, leaving out other health providers that also receive Medicare and Medicaid money,” Ilsley said. “If we mandate our staff to get this vaccine, they will be able to go to other clinical settings to work that do not have this mandate.”

Vaccination rates for nursing home workers in both Vermont and New Hampshire are nearly 80%, well above the national average of about 60%. The potential gains earned by requiring the shots in the Twin States will be smaller than those in states with lower vaccination rates, Williams said.

“It’s going to be really tricky,” Williams said.

Due to these challenges, it would be a good time for the federal government to release some additional “provider relief funds” for nursing homes, Williams said.

The gains and potential losses of a vaccine mandate at Randolph’s Menig Nursing Home are small because 97% of workers there are already vaccinated, said Ursula Margazano, vice president of senior services for Gifford Health Care, Menig’s parent organization.

“The staff that have opted out of vaccination at this time have medical concerns and/or have voiced wanting to wait until emergency use status is modified to Food and Drug Administration-approved,” Margazano said. She did not indicate whether those few workers who remain unvaccinated would be swayed by Monday’s announcement that the Pfizer COVID-19 vaccine had received full FDA approval.

“While there is concern we may lose staff due to the mandate, the health and welfare of our residents and vaccinated staff is of highest priority in the fight against COVID,” she said.

Nursing home workers looking to switch jobs due to vaccine mandates might find it difficult to find other jobs in health care in the Upper Valley now that Dartmouth-Hitchcock Health is requiring all its employees be fully vaccinated by the end of next month. Genesis HealthCare, which operates nursing homes in Lebanon and Claremont and is the largest nursing home operator in New Hampshire and runs hundreds of facilities across the country, also previously announced it was requiring workers to get the shots.

Officials at Genesis, which required that current staff, visiting providers, caregivers and on-site vendors have at least a first dose of a COVID-19 vaccine by Monday, said they hope the growing wave of employer vaccination mandates will limit the impact of the mandates on staffing, according to Lori Mayer, a spokeswoman.

“Thus far, we have been heartened by a very positive response — thousands of employees who had already scheduled vaccinations, many more who were hesitant agreed to get vaccinated and tremendous support from those already vaccinated,” Mayer said.

Though there are fewer and fewer Upper Valley health care employers who aren’t requiring workers to get the shots, it is still possible that workers may leave the field entirely, said Derek Ferland, Sullivan County’s manager.

“The X factor will be if people decide to change careers,” Ferland said. “Because there are plenty of other jobs that are paying competitive wages and, if people feel strongly enough about the vaccine, they can choose to transition into something else. That’s impossible to say.”

Sullivan County nursing home in Unity has seen some positive response thus far to an incentive program the county is offering to employees who show proof of vaccination by Oct. 1, Ferland said.

The county is offering $300 to any staff member who voluntarily provides proof of being fully vaccinated and is also set to offer a few lottery-style raffles for some $1,000 cash giveaways. The Sullivan County delegation authorized the use of $100,000 from the American Rescue Plan Act for the incentives.

Sullivan County nursing home had five staff members vaccinated just last week and is gearing up for a vaccine clinic on Tuesday, said Ted Purdy, the nursing home’s administrator.

“We are optimistic that our incentive and education will minimize vaccine hesitancy and we will have most of our staff vaccinated before the federal mandate is in place,” he said.

The Biden administration has said it will take several weeks to develop the new emergency regulation regarding a vaccine mandate for nursing home workers.

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.

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