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Nursing homes, already facing staffing crisis, grapple with vaccine deadline

Providence Journal - 10/1/2021

The clock is ticking for Rhode Island nursing-home staff waiting to get their COVID-19 vaccines. For some, time is already up.

Faced with the prospect of losing their jobs, more workers have opted for the jab over unemployment, though a staffing shortage still exists.

At Cherry Hill Manor Nursing and Rehabilitation Center in Johnston, six staff members have already left their jobs, sure that they would refuse the vaccine, and another six are working under a corrective action plan, which allows facilities to extend the Oct. 1 vaccine deadline to Oct. 30 if they face staff shortages that could compromise patient care.

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According to Kathleen Gerber, the center's administrator, four of the six are planning to get their shots while two are not, and may leave.

The center, which has 228 employees, is already stretched thin and no longer operating as a profitable business that will be able to sustain itself in the long term.

Gerber said that unless Cherry Hill hires more staff within the next 30 days, it will have to reduce its patient load. It is already on what Gerber described as a "one-in-one-out basis" whereby no one may be admitted until a patient has left.

On Wednesday, a patient who had left temporarily for medical care attempted to return to the center, but was unable to get his room back.

"We were not able to bring back a patient that had lived here for a significant amount of time, considered this their home, had gone out to the hospital, did not have the means to pay for a bed hold, and when he was deemed ready to return, we were not able to hold his bed," Gerber said.

Gerber said the number of patients at the home was "extremely low."

"We can't stay in business at this level," she said. "And there's just no nurses out there to be had to hire."

Though the departure of six employees may not sound like much, Jim Nyberg, executive director of LeadingAge RI, a nonprofit with 13 nursing homes in the state, said even small losses are too great to bear.

"Even if a nursing home has to let two or three people go, that's a huge problem because they're already severely constrained in terms of staffing," he said.

Nicholas Oliver, executive director of the Rhode Island Partnership for Home Care, which represents 30 licensed home and nursing agencies in the state, is already facing a crisis of its own. According to Oliver, one in seven of home care workers remain unvaccinated.

"We are the lowest reimbursed health-care provider in the long-term care system," Oliver said. "We can't compete with hospitals and nursing homes for wages and benefits, never mind hazard pay and sign-on bonuses that we just don't have the financial resources to provide."

Oliver's concern now, he explained, is that home care workers may be called upon to fill staffing gaps at nursing homes.

"There's no substitute for the substitutes," he said. "So when we do not have enough staff, that means vulnerable, homebound patients do not get the care that they need."

Oliver predicts that will lead to an increase in emergency room visits and hospitalizations, which he said the state cannot afford with workforces overburdened there, too.

More: RI judge strikes down challenge to state vaccination mandate on religious grounds

Neither Nyberg nor John Gage, president of Rhode Island Health Care Association, which represents 64 nursing homes, had fresh data on how many employees are vaccinated at the facilities they represent.

Earlier this week, Gage estimated that 706 of the 10,137 workers would be lost. On Friday, he suggested the numbers may have changed.

"Anecdotally, I've heard that more people have chosen to get vaccinated as it became clear that the challenges are going to fail and they weren't budging from the deadline," Gage said. "But it's obviously not 100%."

Gage urged those holding out to comply with the state's mandate.

"I would encourage them to roll up their sleeve, get vaccinated and come back to work because we need them," he said. "The residents need them."

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