To too many providers, “mandate” remains a dirty word when it comes to COVID-19 vaccinations — both as a threat to employee morale and a potential new labor challenge in a nearly impossible job market.
But the pressure on the skilled nursing industry is growing with the fast-approaching requirement to report weekly staff vaccination rates, which federal regulators will make public to consumers. It’s time to consider which will hurt worse: losing a few employees or losing business (and maybe your reputation) because of vaccination holdouts.
If you’ve held off on mandating over workforce concerns alone, consider the scope of the fallout reported by early mandate adopters:
- At Jewish Senior Services, a skilled nursing provider in Connecticut, CEO Andrew Banoff reported he lost 15 to 20 of 750 workers after a mandate that went into effect May 1. He can now tell resident families and prospective families that 95% of his staff is vaccinated. The mandate loss rate equates to 2% to 2.6%.
- In Pennsylvania, Bucks County-owned Neshaminy Manor let go five employees (only one a full-time staffer) who refused to be vaccinated against COVID-19 as a condition of employment by mid-April. Of about 455 employees, 422 had started a two-dose vaccine regime or received a Johnson & Johnson vaccine, while another 23 were granted exemptions for a disability or religious belief. Several others were set to be vaccinated after returning from extended leave. The mandate loss rate equates to 1%.
- And at Juniper Communities, which operates 22 facilities that include Life Care campuses and skilled rehab, about 30 of 1,300 employees quit after a condition of employment was initially announced in January. The mandate loss rate equates to 2.3%.
In an industry that has an annual mean turnover of nearly 130% among certified nursing aides, a 1% to 3% loss seems like a drop in the bucket. That’s not to discount how difficult hiring is right now, but rather to say that providers are used to adjusting for such employment shifts.
The thing is, plenty of providers are spending valuable time and resources they don’t really have on non-mandate-related vaccine efforts, trying to budge that “movable middle” everyone keeps talking about.
But Banoff noted that chief among the employees who left his facility over vaccines were those whose reasoning was influenced by misinformation. The others were apparently just waiting for their bosses to give them a deadline.
How many times should fellow staff members try to convince refusers that the vaccines will benefit them, their co-workers and the residents they care for? At some point, doesn’t that become a labor challenge in itself?
And the longer the efforts go on, the fewer individuals there will be who are likely to be moved by appeals to “do the right thing” or even incentives like cash or extra time off.
After all, if you’ve been offering your staff carrots all this time, those who like sweet and crunchy veggies most likely rushed to the table. The vaccine resistant are less likely to be enticed by what you’re offering, especially if they’re more into, say, desserts.
With Pfizer already seeking full federal approval for its COVID-19 vaccine, emergency use authorization won’t be a real concern for much longer, and that should help more staff members see how safe that vaccine truly is.
If not, maybe it’s time to consider the stick.
It can certainly be wielded along with educational programming and rewards that sweeten the deal to bring the vast majority of staff on board.
But for those whose only real reason for denying a shot is that they can’t be reasoned with, well, they can have their fill of falsehoods and eat them too — as long as they do it in a non-healthcare setting.
Kimberly Marselas is senior editor of McKnight’s Long-Term Care News.