Long-term care industry, facing staffing shortages, on edge over vaccine mandate

A name tag with a sticker on it.
Inez Kalle, director of nursing for Episcopal Homes in St. Paul, Minn., wears a sticker on her name badge to encourage other employees to get their COVID-19 vaccine.
Evan Frost | MPR News file

Updated: 1:40 p.m.

The federal vaccine mandate adds a new wrinkle to an already terrible staffing situation for Minnesota’s nursing home industry. The rule requires companies with at least 100 employees to ensure workers get vaccinated against COVID-19.

"For this rule to land in the midst of what we, by any measure, have as the most severe worker shortage we've ever experienced, creates a scenario where people will leave our field. They'll leave this long-term care career rather than be vaccinated," said Gayle Kvenvold, CEO and president of LeadingAge Minnesota, one of two large organizations in the state that represent the long-term care industry.

"And that potentially means that we won't have a sufficient number of caregivers to safely care for those in our nursing homes across the state," she said.

Thursday, the Biden administration announced that all nursing home employees must be fully vaccinated by Jan. 4.

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Kvenvold said statewide, around 75 percent of nursing home staff are vaccinated. But in some facilities — mostly those in areas with lower vaccination rates than the rest of the state — only about 30 to 40 percent are vaccinated. 

“Our greatest hope is that people will get vaccinated. Vaccination has been such a critical part of our COVID-19 battle,” Kvenvold said. “But … for a variety of reasons, many people, including health care workers, have chosen not to be vaccinated.”

The mandate comes at a time when there are, by the industry’s count, 23,000 open jobs in the state in long-term care. That staffing shortage means that 70 percent of Minnesota’s nursing homes are limiting new admissions.

At Warroad Senior Living Center in northern Minnesota, roughly half the staff is vaccinated. Mark Bertilrud, the facility’s executive director, said he currently has about 10 jobs open.

"I'm very worried about what's going to happen,” he said. “If in fact we get to that last day and we have no options with people for exemptions, either medical or religious, and some of that needs to be worked out for exactly what the criteria is going to be for that. But we're in an environment where we can't lose one person."

The administration said late Thursday that exemptions for medical conditions and the practices or observances of religious beliefs, will be allowed.

Bertilrud said the mandate could end up trading one kind of safety for another if the facility he runs doesn’t have enough people “to do all of the things that we need to do on a regular basis.”

“We are going to take a small amount of comfort knowing that everyone in our building is vaccinated when we're short 20 percent of our workforce,” he said.

In a town where manufacturers are offering jobs with competitive pay for workers with no experience, it makes competing that much more difficult, Bertilrud said. He is planning to raise wages for some positions in the coming days, but he said the state should step in and lift restrictions on what facilities can charge, in order to let them compete for employees.

Episcopal Homes in St. Paul introduced a vaccine mandate in September. CEO Marvin Plakut said they lost about 5 percent of their staff.

"And that hurts. But that is recoverable," he said.

However, he points out, the company has one of the higher vaccination rates in the industry already, and they are in a great position geographically for finding workers.

"It's going really well,” he said. “You have to remember, though, we're drawing from a pool that is more likely to be accepting of [the vaccine], in a community where the community, in general, is favorable towards it."

Plakut said that when the rubber hit the road on his company’s mandate, most people did get vaccinated. 

He said they found that personalized, non-judgmental responses to vaccine concerns worked best. Plakut also said it helps when the message comes from a coworker that employees trust.