Staffing has always been a challenge in long-term care facilities – the vaccination mandate could make matters worse
Long-term care facilities could face a serious staff shortage this fall as Governor Inslee’s vaccination mandate takes effect Oct. 18.
Robin Dale, CEO of the Washington Health Care Association, which advocates for long-term and post-acute care facilities in the state, said staff shortages at facilities are a huge problem and will only get worse. .
“Over the past month, we’ve been in situations where I’ve had a few facility members to a staff member (person) away from having to close the facility and relocate residents,” said Dale.
So far, that has not happened, but Dale is wary of what the vaccination mandate might do to facilities already operating with too few caregivers.
These are difficult jobs to fill at the best of times; the shortage of nursing aides and assistants as well as nurses in long-term care facilities in Washington predates the pandemic.
Since 2016, Washington state long-term care facilities have reported the highest number of job openings as well as the highest turnover rates in nurse and caregiver roles in their establishments, depending on the establishment. survey data collected by the Sentinel network.
Bianca Frogner, director of the Center for Health Workforce Studies, studied state health workers during the pandemic. She has seen a steady decline in the number of long-term care workers during the pandemic.
Nursing aides and certified nursing assistants, those who directly care for residents in facilities by helping them eat, wash and use the restroom, among other tasks, must receive hours of training to be certified for do their job, but the pay is often only a little. above the minimum wage.
This workforce is predominantly female, and Frogner said it is likely that many caregivers quit early in the pandemic when their daycares closed and the children were in school online. from their home.
When COVID-19 hit Washington state in 2020, long-term care homes were at the center of concern as the disease swept through facilities before vaccines were available, killing hundreds of elderly residents.
Keeping the virus out of these facilities was difficult at the start of the pandemic and exhausting to follow in the long term. Fatigue and burnout have also likely contributed to some workers quitting their jobs, Frogner said, especially as their jobs have become much more difficult with their health as well as potentially the health of their clients at risk.
More recently, long-term care workers have been hired at larger facilities or different healthcare companies that can afford to pay hefty hiring bonuses and better wages, Dale said.
Hospitals across the state have reported shortages of nurses and other staff during the current COVID outbreak. The Department of Health is working with federal agencies to bring in contract workers to strengthen the system.
But when one position is filled, another opens.
And while there are staffing issues in many areas of the healthcare system, Frogner is concerned that long-term care staff, primarily nursing aides and home helpers, may be at risk.
“I fear that we face an even more acute crisis even further if we do not invest in this workforce,” said Frogner.
With a mandate for immunization across the healthcare industry in Washington state, employees can’t leave a nursing home and go to work in a hospital without being vaccinated. Member facilities of the Washington Health Care Association have said they have lost hundreds of employees due to the impending tenure, Dale said.
Federal data shows that 76% of trained staff at nursing homes in Washington are vaccinated as of mid-September.
“It’s a vastly improved number from where we were a month ago, and I’m encouraged by that,” Dale said.
But the percentage does not include assisted living or other types of health care facilities.
As of September 19, the last update to federal nursing home data, staff immunization rates varied widely.
Nursing homes in Spokane that have submitted vaccine data to the Centers for Medicare and Medicaid have reported staff vaccination rates that ranging from 33% to 83%.
The Department of Health has contracted with ACI Federal to bring health workers to state hospitals and health facilities. Facilities must pay for these workers unless they can contact FEMA to reimburse for care.
Dale said long-term care facilities for the most part lack the funds to cover the high costs of compensating contract workers, at least not for an extended period.
Separately, the Department of Social and Human Services has set up strike teams that work on an emergency basis if a facility needs help staying open. Dale said these teams have helped support installations for days at a time, and the department is trying to build even more teams to help auto installations in the long run.
Hospitals, which have seen patient numbers slowly start to decline over the past few weeks, still have patients ready for discharge but cannot be as there is no room in rehabilitation or nursing homes. long-term care.
Taya Briley, executive vice president of the Washington State Hospital Association, said hospital officials fear patients no longer needing hospitalization may not be referred to reduction facilities such as hospitals. rehabilitation or skilled nursing centers.
Some facilities, Dale said, have come very close in recent weeks to having to relocate their residents due to a staff shortage. Essentially, there comes a time when the number of patients cannot be taken care of by a decreasing number of staff. Dale worries this is happening.
“Almost every nursing home in the state faces this problem of having to limit admissions in order to properly care for the patients they have and it’s a systemic problem,” Dale said.