Finally: Tide turns for vaccine mandates for nursing-home health staff

From the It’s-about-time department: Nursing homes and long-term care facilities finally have started to require their health workers to get vaccinated against the coronavirus.

The federal Centers for Disease Control and Prevention has reported as of Aug. 6 that ~1.6 million long-term care residents and 1.3 million health workers in the care facilities were fully vaccinated.

But with coronavirus cases, hospitalizations, deaths, and community spread spiking this summer — especially due to the unvaccinated and the Delta variant — nursing homes have seen worrisome signs of their own of the pandemic’s resurgence. And they, along with other health care institutions, can no longer ignore the safety and effectiveness of the coronavirus vaccines, the New York Times and other media organizations have reported. As the newspaper noted:

“After sharp drops in infections over the last several months, the number of Covid cases among U.S. nursing-home residents and staff roughly quadrupled from the week ending July 4 to the week ending Aug. 1, according to the Centers for Disease Control and Prevention. The agency’s data show that cases of Covid among residents had risen to 2,092, the highest figure reported since late February. During the week ending Aug. 1, 296 nursing home residents died from Covid, nearly doubling from the week ending July 4. About 133,000 nursing home residents died of Covid over the course of the pandemic, although the death rate has plummeted in recent months with more than 80% of residents now vaccinated. Overall, Covid deaths among nursing home residents and staff members accounted for nearly one-third of the nation’s pandemic fatalities.”

Owners and operators of long-term care facilities were loath to mandate vaccinations, which their health workers were reluctant to get. The bosses feared losing already hard-to-find staff. The health workers in the institutions already were over worked, under paid, under trained, and stressed to the max, especially because many of them — just to make ends meet — were holding down two or more jobs at care facilities near each other. They were suspicious if not hostile toward their nursing home employers already, and leadership in the facilities tended to lack credibility in convincing reluctant or resistant health staff to get coronavirus shots, especially if the vaccines might cause side-effects that could cost them pay (especially since employers were not offering them paid sick leave).

The Trump Administration, as it had with so much of its pandemic response, had an early and shambolic rollout of vaccines in nursing homes and other long-term care facilities, with the Biden Administration ultimately getting good results among residents but not necessarily staff.

As weeks have ground on, this stalemate might have continued. But industry leaders and a raft of professional associations and groups in health care have built a consensus to require coronavirus vaccinations, arguing it would be wrong for health workers to fail to take precautions to safeguard those in their care.

California, Massachusetts, and the cities of Denver and San Francisco have stood up for consumers and patients, requiring staff in high-risk situations, and especially in health care settings, to be vaccinated. Federal courts have declined to support resistance by health workers in hospitals or students at colleges and universities to vaccine mandates.

In long-term care, experts pointed to a vaccine requirement for staff in the giant Genesis health system as a turning point, as the Associated Press reported:

“The new requirement at Genesis Healthcare, which has 70,000 employees at nearly 400 nursing homes and senior communities, is the clearest sign yet that owners may be willing to risk an exodus at already dangerously understaffed facilities to quickly vaccinate the 40% of workers still resisting shots and fend off the surging delta variant … ‘It’s so easy now to say, “Well, Genesis is doing it. Now we’ll do it,” said Brian Lee, who leads Families for Better Care, an advocacy group for long-term care residents. ‘This is a big domino to fall.’”

Lest any nursing home owners or operators injure their arms, giving themselves congratulatory pats on the back, they may wish to read the comments published online on news articles excoriating them about their facilities and their tardy vaccine requirements. Common sense argues this is a step long overdue — especially as the shots may not offer maximum protection to residents who are old, sick, injured, and disabled enough to require 24/7 care. The Delta variant is savaging younger, healthier, and unvaccinated people, and every effort should be made to protect the vulnerable from breakthrough infections, including those potentially spread to them by health workers.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them and their loved ones by neglect and abuse in nursing homes and other long-term care facilities.

The pandemic became a deadly way for the public to see the many unacceptable ways that nursing home owners and operators pursued profits at the expense of residents and their loved ones. The industry claims it did the best it could under tough, unforeseen circumstance. But even as taxpayers have dumped billions of dollars to shore up the needed facilities, where is the accountability for the debacle that occurred with them?

Critics love to slam malpractice lawyers and the civil justice system. But many nursing home residents and their families, struggling still with the consequences of the pandemic, are thinking hard if their best recourse may be lawsuits to seek justice for wrongs done to them.

Nursing home care, just to remind, is expensive, with the median cost of a private, single-room in a facility running $102,200 annually. It is hard to listen to owners and operators of the institutions cry poor me, knowing that so many of these outfits have become giant corporate piggy banks, including for profit-hungry hedge fund investors.

The owners and operators of facilities don’t seem to grasp the concept of caring for their No. 1 “customers,” residents and their loved ones, nor do they seem to grasp the meaning of “essential workers” like health staff. Perhaps if the Wall Street crowd, or the suit-wearing MBAs who run long-term care chains spent more shifts with health aides who bathe, feed, transport, and care for the vulnerable around the clock they might see why an average pay of $14 an hour isn’t enough and might make staffers resistant to — anything.

We have a lot of work to do to ensure that nursing homes and other long-term care facilities are safe, hygienic, and welcoming places to live — not warehouses for people to suffer, get sick, and worse.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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