A recent University of Pennsylvania School of Nursing study reveals that after making the COVID-19 vaccine a condition of employment (COE), one 180-bed skilled nursing facility (SNF) in Philadelphia saw 17 staff members, or 6.9% of the overall staff, resign from their positions.
An additional three were exempt for religious or medical reasons and four employees remained on a leave of absence as nearly 90% of the facility’s 246 staff members received a vaccine by May 1.
Those numbers proved to be much lower than the 20-30% staff exit that was predicted by some operators following the announcement that the Biden administration planned to mandate the vaccine for nursing home staff this week.
Featured in the Journal of the American Medical Directors Association, the Pennsylvania study shows that vaccination clinics, written communication, internal communications and education sessions can be beneficial in getting more staff on board with the vaccines, though the researchers admitted limitations with the study.
“Geographic areas and individual facilities experiencing difficulty recruiting and retaining staff may hesitate to implement a COVID-19 vaccination COE,” the researchers said. “The systemic challenges of low pay and staff turnover in nursing homes complicate the implementation of policies that could result in even minimal resignations.”
The national percent of vaccinated nursing staff is currently 60.5%, according to the Centers for Medicare & Medicaid Services (CMS), as Pennsylvania is slightly above the national average at 60.9%.
Pennsylvania’s Department of Health announced this month it expects all of the state’s nursing homes to have at least 80% of their staff vaccinated by Oct. 1.
Facilities that do not meet that expectation will be subject to more frequent testing for unvaccinated employees.
For the nursing home featured in the JAMDA study, pairing the COE with intervention and support from facility leadership proved to be a big help in getting its numbers up. The SNF, located in an urban area and operated by a not-for-profit non-chain organization, collaborated with the National Union of Hospital and Health Care Employees regarding plans to include a COVID-19 vaccination condition of employment.
When the COE was announced on Feb., fewer than half of the staff were vaccinated, the study said.
During the next four months, nursing home leaders provided eight written handouts about COVID-19 to staff, hosted five on-site vaccination clinics and two virtual presentations. The medical director at the building was ultimately the staff member chosen to deliver the news of the COE.
While financial incentives and paid time off to encourage vaccines were considered, ultimately the employees themselves felt these approaches sent the wrong message about vaccine safety and coercion.
Frequent, personalized outreach to address vaccine hesitancy proved to be a great tool for the organization, which provided it multiple opportunities to address questions and concerns the staff had about vaccines in order to achieve high staff vaccination rates and minimal staff turnover.
Variables influencing the decision to implement the COE included staff willingness, availability of resources and regional context.
While the study highlighted the successful implementation of a COVID-19 vaccine mandate at a Pennsylvania SNF, the researchers admitted that such a measure wouldn’t work everywhere and requires individualized consideration as implementation of new vaccination COE can damage vaccine acceptance if done without caution.
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