Nursing homes on brink as COVID vaccine mandate may worsen staffing crisis

Nursing homes on brink as COVID vaccine mandate may worsen staffing crisis


CMS is predicted to lay out its mandate for nursing homes to require staff vaccinations in mid-October.

For Spiro, this could spell disaster. He projects only about 40 percent to 60 percent of his staff is fully vaccinated.

“The majority of our staff are vaccinated, but enough have refused that the mandate may be a big problem,” Spiro said. “If we lose 10 percent or 15 percent of our labor force, I don’t know how this industry would carry on right now.”

Spiro isn’t alone, as 78 percent of respondents to the AHCA/NCAL survey are concerned they will have to close down if the shortages persist or get worse due to the mandate.

According to CMS, about 64 percent of the more than 520,000 nursing home staff in the U.S. were vaccinated against COVID-19 as of Sept. 12.

That leaves more than 187,000 yet to be inoculated, including Chiquita Keen-Johnston, a nursing assistant at Beaumont Commons nursing home in Farmington Hills.

Keen-Johnston has been a nursing assistant for 32 years, including 13 years at Beaumont Commons. But she has no plans to take the COVID-19 vaccine.

Instead she has sought a medical exemption for an undisclosed condition. Employers are legally required to allow certain medical exemptions to the vaccine, but the threshold is very narrow.

Keen-Johnston falls under Beaumont Health’s vaccine mandate, which was issued last month and goes into effect on Oct. 18, that ultimately will be trumped by CMS’ order.

“I am not taking the vaccine,” Keen-Johnston said. “I have not heard back on my medical exemption. But I will let them fire me if I don’t get it.”

Keen-Johnston said all the unvaccinated nursing assistants at Beaumont Commons are waiting to be terminated instead of quitting so they can draw unemployment while they seek employment elsewhere. Keen-Johnston said she plans to devote more time to her small business, Unique Touch 919, which makes personalized items such as memorial blankets.

Samuel and the ACHA have been in communication with CMS in hopes the agency will allow for a more rigorous COVID testing regimen for the unvaccinated instead of an all-out vaccine mandate. But she’s not overly hopeful the mandate will be watered down.

“Until we get the pandemic under control, this is going to be a challenge in the industry,” Samuel said. “Our staffing challenges feed off the pandemic. We just need to get it under control.”

Spiro said the nursing home continues to apply the pressure via information, but only only so many people are willing to take the vaccine.

“We have digital billboards in our buildings and post information everywhere we can,” Spiro said. “We’re walking around now telling people the mandate is coming, but we’re running out of time. We tell them to look around the building. It’s safe. We haven’t seen one adverse reaction.”

Robinson-Lane said most nursing home staff will ultimately align with hospital workers who opposed the mandate but ultimately most got inoculated.

For instance, Houston Methodist mandated the vaccine in June for its roughly 26,000 employees, and only 153 quit or were terminated at the deadline.

“Nursing assistants and staff will complain, but when the mandate comes down, they mostly comply because they need the work,” Robinson-Lane said. “With the mandate being industrywide, there’s not as many places to go. People just won’t have the flexibility they do right now.”


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