COVID vaccine mandate a ‘powder keg’ for nursing homes, industry leaders say

The exit rate of nursing home staff has been 1.5 times higher than the hire rate, which some industry leaders described as an "unprecedented workforce crisis."

President Joe Biden delivers remarks on COVID-19 vaccinations in June. (White House/Flickr)

The Minnesota Senate’s Human Services Reform Committee held a hearing Wednesday on how a new COVID vaccine mandate will affect the state’s nursing homes.

The hearing featured testimony from Nicole Mattson, vice president of strategic initiatives at Care Providers of Minnesota, and Kari Thurlow, senior vice president of advocacy at LeadingAge Minnesota. Both women expressed grave concerns with the mandate and its potential impact on nursing home staffing levels.

On Nov. 5, a federal mandate went into effect for Medicare and Medicaid certified providers such as hospitals, nursing homes, hospice facilities, and health agencies. This particular mandate, issued by the Biden administration via the Centers for Medicare and Medicaid Services (CMS), is stricter than the Department of Labor’s OSHA mandate because it does not allow an option for regular testing in lieu of vaccination.

According to Diane Rydrych, acting assistant commissioner of the Minnesota Department of Health, health care workers must get their first dose by Dec. 5 and then their second by Jan. 4, 2022. Those with certain medical conditions and religious objections are allowed to request an exemption.

Mattson testified that many skilled nurses, roughly 12,000 throughout Minnesota, remain unvaccinated, despite strong encouragement, incentives, and persistent education. The exit rate of nursing home staff has also been 1.5 times higher than the hire rate.

“We certainly hope that the mandate will encourage some who have been hesitant. But know that many remain steadfast in their declination. And we are very concerned about [the] implications for our workforce,” she said.

Thurlow testified with great urgency, calling the situation “a potential powder keg with a very short fuse for long-term care” and adding that there are currently no concrete solutions in place to solve the “unprecedented workforce crisis.”

She said the state of Minnesota is not prepared to lose thousands of nursing home workers — and some nursing home facilities cannot even afford to lose one or two workers due to chronic understaffing.

Vaccination compliance rates are not evenly distributed throughout the state either, with Thurlow testifying that some nursing homes have only 50 percent compliance thus far.

Both Mattson and Thurlow pleaded with the committee to help them devise a plan to retain staff and a contingency plan if significant numbers of nursing home staff leave over the mandate. They are also looking to use money from the American Rescue Plan to permanently increase staffing wages.