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Why NC nursing facility residents and their families are living in fear

On Aug. 25 the Biden administration announced that COVID-19 vaccinations would be required for all nursing home workers, or facilities would risk losing federal funds.

It was a welcome announcement to the families with loved ones in nursing facilities. Unfortunately, this requirement is slow in coming.

The promise of protection is no comfort to William Hughes of Pinehurst whose wife, Anne Hughes, succumbed to COVID while a resident of a N.C. nursing home. Anne was vaccinated, but not all of her nursing facility caregivers were. Her husband’s question for all of us is: “What will it take to convince healthcare workers to be vaccinated — and facility owners to require it?”

North Carolina residents and their families are living in fear. Even though they may be fully vaccinated and take every possible precaution, they are likely surrounded by unvaccinated caregivers. New data show that 18 months into the pandemic vaccination rates for nursing home staff in North Carolina lag, contributing to continued outbreaks among residents.

Our nation’s first nursing outbreak occurred in Kirkland, Wash. in February 2020. In all, 37 people died. The outbreak was fueled by staff members.

The virus found the perfect host environment — a congregate setting filled with vulnerable residents, people with impaired immune functions and serious underlying medical conditions. This virus can be lethal, and particularly so for long-term care residents.

While most residents of nursing facilities are now vaccinated, many of the staff still aren’t — and staff vaccination rates can vary widely by facility. For example, in Mecklenburg County one facility has a staff vaccination rate of more than 93% while the rate at another across town is less than 20%.

Some providers instituted their own mandatory policy and have achieved virtually complete coverage, while others are still trying to increase vaccination rates. According to AARP, the percentage of nursing homes meeting an industry target of at least three-fourths of staff fully vaccinated was 35% in mid-September.

It’s difficult to explain the wide variability in vaccination rates, but this is, for the most part, a for-profit industry, and we have always had owners with a corporate culture of doing nothing beyond minimum requirements as they pertain to their bottom line.

We know that vaccination in facilities saves lives. A recent N.C. Department of Health and Human Services report indicates that a decrease in cases and severe illness in facilities can be directly attributed to vaccinations for residents and staff. We also know the industry supports requiring staff vaccination.

Adam Sholar, CEO of the North Carolina Health Care Facilities Association said, “We need to go further and faster with increasing our vaccination rates.” He issued a letter in support of facility vaccination requirements. And, the federal government is on the cusp of issuing a mandatory national policy related to nursing homes.

Staffing shortages and fear that vaccination requirements will promote even more difficulties in recruitment and retention of direct care workers is generally cited as the reason facilities stop short of imposing their own restrictions. But the experience of providers who’ve imposed their own mandates or states that have imposed mandates does not support this industry concern. Most workers comply with requirements, particularly in facilities that have a history of support and respect for their workers. And most workers want to keep working, particularly when the requirements they oppose apply equally to everyone.

North Carolina residents and their families should not have to live in fear. It’s past time for N.C. leaders to step up and issue a statewide mandatory vaccination policy for direct care staff, including all settings of long-term care, not just nursing homes.

Other states have done it. It’s time we answered William Hughes’ question and addressed those fears — no more patient deaths should be needed to convince healthcare workers to be vaccinated.

A state, enforceable mandate is what it will take. It won’t save Anne Hughes, but it may save the lives of many others currently in care.

William Lamb is board chairman of the Friends of Residents in Long Term Care.