Why Congregate Care Facilities Don't Require Employee Vaccinations and What Biden's Mandate Might Do
You may recall that in February 2020—just when the Apocalypse was getting started—there was a huge outbreak of COVID-19 in nursing homes in Washington State, leading to many deaths. An epidemiological study concluded:
Long-term care facilities are high-risk settings for severe outcomes from outbreaks of Covid-19, owing to both the advanced age and frequent chronic underlying health conditions of the residents and the movement of health care personnel among facilities in a region.
In many states, nursing home personnel have disappointing vaccination rates, as shown in this August 29 data from the Center for Medicare & Medicaid Services:
But nursing homes aren't the only facilities dealing with residents of "advanced age" who have "frequent chronic underlying health conditions." So do other congregate care facilities like assisted living, memory care, group homes, and the like.
Will Humble, former AZDHS Director and current Executive Director of the Arizona Public Health Association, pointed out in a tweet that nursing homes in Arizona are required by state law to do infection control (assisted living places, strangely, are not). He couldn't understand how these facilities in Arizona could be in compliance if they allow unvaccinated employees to run around their facilities.
So why don't congregate care facilities require staff to be vaccinated? One memory care director I spoke with said they are afraid that if they require vaccinations, their vax-reluctant staff will quit and go work at some other facility that doesn't require vaccinations.
Another person I spoke with, who deals with senior issues more generally, said that worry was too narrow. They are also afraid that low-skilled staff might quit and go work for $20 per hour at Walmart or some similar place. Many nursing homes are understaffed by 25% as it is, according to this source, and any further staff shortage could jeopardize their ability to function.
This is another manifestation of the current job market, which for the first time in decades favors workers. It causes me some concern how President Biden's new mandate plan might interact with this change.
If his Medicare-funding trigger applies only to skilled nursing facilities, then it could cause a movement of employees from those to other congregate care facilities, increasing the number of unvaccinated employees in those less-regulated facilities. If it applies to all congregate care settings it could cause an exodus from those places to non-care jobs.
"Dorriss In Nursing Home" by tmat1075 is licensed under CC BY-NC 2.0
