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Healthcare facilities face challenges getting staff immunized



Courtesy / Centers for Medicare and Medicaid Services

Several nursing homes have rebuffed reports that far less than 50% of their staff have been vaccinated against COVID-19.

Some data may have been incorrectly entered in an information system offered by the Medicare and Medicaid Service Centers (CMS).

However, CMS is still the best resource for finding all of this data in one place. And overall, less than 50 percent of Missouri nursing home staff have been vaccinated (47.7 percent), although only 42.8 percent of skilled Missourians have completed vaccines.

Missouri ranks 48th among states in percentage of nursing home staff who have completed vaccinations. It is 51st, if you consider the District of Columbia, Puerto Rico and Guam.

Thus, getting vaccines accepted by low-paid staff remains a challenge.

Overall, local health care facilities and the state have done a fairly good job of getting residents vaccinated. Friday, several local nursing facilities, such as River City Living Community, 3038 W. Truman Blvd. (94.6 percent) and StoneBridge Villa Marie, 1030 Edmonds St. (93.8 percent) have maintained vaccination rates above 90 percent among residents.

Heisinger Bluffs Lutheran Home, 1002 W. Main St. (85.1%); StoneBridge Adams, 1024 Adams Street (89.9); and Oak Tree Villas, a StoneBridge community, 3108 W. Truman Blvd. (88.5%) had maintained rates above 90% among residents a few days earlier.

However, with the turnover of residents, the numbers fluctuate daily.

Staff at local nursing facilities remain above the state average for vaccinations. They also experience fluctuations in completed vaccinations – similar to those that occur in residents, but in smaller increments.

For example, the Jefferson City Manor Care Center, 1720 Vieth Drive, showed that 51.2% of staff had been vaccinated earlier this week. CMS figures showed the facility was down 49.4% on Friday. StoneBridge Adams, which was 63.6% earlier in the week, climbed to 66% on Friday.

The current vaccination rate for residents of all StoneBridge facilities on Wednesday was 95.2% and 58.6% for staff, said Craig Workman, spokesperson for the nursing care provider.

“This compares favorably to the Missouri state averages for nursing homes and skilled nursing facilities,” Workman said.

The organization does not require vaccinations, but strongly encourages them for residents and staff, he continued. It provides educational materials, posters and promotional videos, and also promotes the Missouri Immunization Lottery Program.

“We bring our pharmacy vaccination clinic to each facility every four weeks to promote free on-site vaccinations and answer questions. Despite these efforts, the spread of disinformation on social media and mistrust of the government promoting the vaccine are the biggest challenges we see in getting more of it. staff members to accept vaccinations, ”Workman said.

The facilities transmit data to the federal government on a weekly basis, he said.

While the COVID-19 pandemic may have highlighted staffing issues in healthcare facilities, they existed long before the coronavirus took hold, said Steve Bollin, director of licensing and regulation at the Department of Missouri Health and Main Services.

Nursing home staff are generally a bit younger than in other health facilities. They provide day-to-day care to people who are otherwise unable to take care of themselves or who do not have the proper care at home. And, the pay may be lower than that of other jobs.

Thus, turnover can be a problem for nursing facilities.

“There is a nursing shortage that has been going on for quite some time,” Bollin said. “When COVID-19 hit, staffing was affected by two factors – nurses were drawn to agency staff, where they were paying higher salaries. occupy patients fell ill. “

There was already a shortage of Patient Care Assistants (PCAs) and Certified Practical Nurses (CNA), who work directly with patients. By having staff away for long periods of time sick or in quarantine, the facilities were really hit hard.

The financial reimbursement structure is different in long-term care facilities.

“You are meeting basic daily care needs. You are not dealing with an acute illness or injury or something that requires a higher level of care or intervention,” Bollin said. . “It really is a more continuous maintenance of health for people who are unable to take care of themselves.”

Some are in the facilities for short periods. Some for long periods. Some for the rest of their lives.

The requirements are somewhat lower for nurses than in hospitals.

“It’s hard work. The requirements are different,” he said.

Statewide, there just aren’t enough staff for everyone.

Just under 49% of Missouri nursing home staff are vaccinated, according to the CMS.

“It’s actually consistent with what we’ve seen in general when we have nursing homes or facilities that have outbreaks. We saw that it was a pretty typical experience for the staff to be around. by 50%, “Bollin said,” while residents are in the 90-95 percent range. “

His division tracks outbreaks on a daily basis (one case is considered an outbreak), he said. Virulence in healthcare facilities was not as high as it was for the first round of COVID-19, he continued.

“Although we are still seeing a pretty large number. What we are seeing – as the data shows – the largest percentage, the last time I heard over 95% of those infected with the delta variant were not vaccinated, ”says Bollin.

Outbreaks have occurred among residents and staff. Many residents have had cases of breakthrough. It’s not unique to Missouri, he said.

“We have seen that for residents who have had breakouts, they tend to have less acuteness of symptoms. They are not as sick,” he said. “We continue to monitor this very closely. We report this daily as part of our COVID-19 appeals. We keep a very close eye on how things go in nursing homes. “

The state monitors health care facilities by region, he added. However, if there is a major outbreak in a specific facility, he also keeps a close eye on it. If there is anything DHSS can do to help, they will follow up.

Institutions call DHSS if they need help, he said.

The most common conversation, said Bollin, is about how establishments can find more staff.

Gov. Mike Parson took action on Tuesday to help nursing facilities tackle the problem, when he announced $ 15 million was to be provided for support for healthcare workers.

Missouri will commit $ 15 million to provide healthcare personnel to all CMS licensed or certified critical access, acute care and long-term care hospitals. Funding will be provided on the basis of a firm and fixed endowment rate.

The whole point of the new programs is to make staff available.

“We need to understand how this can help long-term care facilities,” Bollin said. “They are the next line of care. If (patients) no longer need acute care, but cannot return home, they go to a qualified nursing or nursing home facility. long lasting – the next establishment in line until they can get home. If we can’t get people in due to staffing issues, it’s going to slow down the process. And it’s blocking things upstream, especially in the emergency department.

DHSS is well aware of the challenge.

“It’s all a mix of (conditions), especially with intensive care patients – a lot of them will have been intubated for a few days to a week,” Bollin said. “Until you find a suitable place for this person, it causes a blockage and affects healing at all levels.”