Norris Cunningham

While staffing shortages have plagued the long-term care industry for quite some time, the coronavirus pandemic has certainly shone a spotlight on the issue and worsened it.  

At the start of the pandemic, facilities were faced with the dilemma of whether to mandate vaccination for staff. Initially, facilities opted for a voluntary, incentive-based approach to encourage vaccinations.  This was not only because the vaccines were still new but because of retention concerns.  Facilities feared that mandating vaccines would lead to resignations, and the fear was not unfounded.

Now, as the Centers for Medicare & Medicaid Services, in collaboration with the Centers for Disease Control and Prevention, is developing an emergency regulation requiring staff vaccinations within Medicare and Medicaid-participating nursing homes, that fear is simply growing.

 A new industry survey reports that only 1% of nursing homes say they are fully staffed, while 89% of nursing homes report moderate or severe shortages.  Fifty-eight percent of nursing homes report they are limiting admissions because they do not have enough staff to care for residents.  More than one-third of nursing home operators say they are concerned they will have to shut their doors if the staffing shortage does not turn around.

 Now facilities must worry whether mandatory vaccination will greatly increase the risk of staff shortages. Companies have seen immediate staff resignations after mandating vaccination. There are some encouraging signs that fears of employee resignations were exaggerated.

Angela Rinehart

A nursing facility in Atlanta had only 10 of 180 employees quit because of its vaccine mandate, while another  in New Jersey saw only 5 of 527 workers resign.  Regardless, the risk of further staff shortages related directly to the vaccine mandate is very real.

So, what can, and should, facility operators do to address the ever-increasing concern for staff shortages in light of CMS’ upcoming mandatory vaccination rule?  It’s important to educate and plan ahead for this new requirement.

For example, consider bringing in medical experts to talk to staff, schedule individual meetings with those who are hesitant, and invite staff to gather for meetings to express concerns and have questions answered.  Such practices have resulted in positive outcomes for many operators.

Lastly, the elephant in the room is staff pay.  Long-term care facilities need to be able to offer competitive wages if they are to boost their workforces and avoid ongoing staff shortages, negatively affecting patient care and limiting admissions.  The president of AHCA said that additional funding support from state and federal governments is needed to do so. 

In fact, national groups have called on the Department of Health and Human Services to declare a national nurse staffing crisis and prioritize nursing workforce policies. The staffing shortage in healthcare was not caused by operators and the myriad solutions required to fix the problem must come from all interested parties — particularly governmental entities.  

Norris Cunningham is a founding shareholder and leads the Health Care Practice Group at Katz Korin Cunningham PC (KKC) in Indianapolis. Contact him at [email protected] 

Angela Rinehart is an associate attorney in the Health Care Practice Group at KKC and focuses her practice on the defense of long-term care providers. Contact her at [email protected].

Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.