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Some early success for vaccine mandates in nursing home

Monitor staff
Published: 10/2/2021 4:00:06 PM

Later this month, 97% of Merrimack County Nursing Home’s staff are expected to be fully vaccinated against COVID-19 — a rate significantly higher than both the national and statewide averages for nursing home staff.

The secret behind the home’s high vaccination rate was not incessant education, financial incentives or gentle prodding. It was a vaccine mandate that offered few exceptions.

Matt Lagos’ facility was the first county nursing home in New Hampshire to mandate the COVID-19 vaccine for its employees. The decision was a difficult one — with only 64% of his employees vaccinated by mid-August, he risked losing a third of the home’s staff in a market where demand for licensed nursing assistants dwarfs the supply.

“There was a lot of controversy, and there was a lot of people in panic mode,” Lagos said.

He said some former employees and existing employees under pseudonyms began arguing with residents and families in the comments section of the facility’s Facebook page. Several people also shared Lagos’ post announcing the mandate, including several who identified themselves as employees.

“Looks like they’ll be losing workers,” one commenter wrote.

“Let them fire you,” another said.

Ultimately, the threats didn’t pan out. Only a dozen people out of more than 350 staff members quit. When the home’s administration set a deadline for mid-October, most of the people who threatened to leave signed up to get vaccinated, he said.

“Every staff loss is significant,” he said. “But we did not see a mass exodus.”

The home allows religious and medical exemptions for the vaccine mandate; one requires a doctor’s note, and the other requires a written declaration of a deeply held belief that prevents them from getting vaccinated. Lagos said few people have applied for those exemptions.

Merrimack County Nursing home may be an early indicator that mandates will help bolster vaccination rates in nursing homes without sending them into a staffing crisis.

Most other facilities in the state are waiting to hear more about a federal plan that requires nursing homes to mandate the vaccine for their staff in order to participate in Medicare and Medicaid. Brendan Williams, the president of the New Hampshire Health Care Association, said nearly all nursing homes in New Hampshire rely on these federal healthcare programs to keep their doors open.

David Ross, the administrator of the Hillsborough County Nursing Home to the south, said only two of his employees have left as a result of the federal mandate. He anticipates that number will increase as the federal government sets deadlines for vaccinations. Few details about the nationwide mandate have been posted, including information about what exemptions will be available for unvaccinated staff.

“The employees that are in limbo,” he said, “we’ve had folks saying, ‘If it’s coming, do I leave or do I not?’ ”

Ross said he hopes unvaccinated staff will be given the option to stay in their roles and undergo regular testing, as employees of large private companies are allowed to do under their respective federal mandate.

He said he’s fielded several calls from prospective employees who are looking for a facility that doesn’t require the vaccine.

“We’ve recommended that they not make that move, that they really revisit whether or not they want to get vaccinated, and whether or not working in healthcare is the right place for them,” Ross said.

Teddy Rosenbluth bio photo

Teddy Rosenbluth is a Report for America corps member covering health care issues for the Concord Monitor since spring 2020. She has covered science and health care for Los Angeles Magazine, the Santa Monica Daily Press and UCLA's Daily Bruin, where she was a health editor and later magazine director. Her investigative reporting has brought her everywhere from the streets of Los Angeles to the hospitals of New Delhi. Her work garnered first place for Best Enterprise News Story from the California Journalism Awards, and she was a national finalist for the Society of Professional Journalists Best Magazine Article. She graduated from UCLA with a bachelor’s degree in psychobiology.

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