ROCHESTER — According to the Centers for Medicare & Medicaid Services, just under 80% of Minnesota nursing home workers are vaccinated for COVID-19. North Dakota and South Dakota follow close behind, at just over 78% staff vaccination rates.
Though these are higher than the percentages of care workers vaccinated in Oklahoma and Missouri, they come in 10 points lower than the 90% and higher staff vaccination rates in California, New York, Colorado and Alaska.
Thanks to a recent Supreme Court decision allowing vaccine mandates in health care, Minnesota and the Dakotas having 20% of nursing home workers unvaccinated may soon become a staffing problem.
The nation on Thursday, Jan. 27, reaches the first of three federal deadlines en route to 100% nursing home employee vaccination in order for a facility to receive payments from Medicare and Medicaid. All care home staff must have received one dose or filed an exemption request by Thursday.
In a concession, the policy allows homes with 80% staff at one dose to continue, as long as they have a plan to reach full vaccination or exemption within 60 days.
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A deadline for 100% to have received a second dose falls on Feb. 28 and, by March 30, the rule allows enforcement actions to begin, using compliance surveys conducted by contractors.
"We believe that number is low," said Patty Cullen, CEO for Care Providers MN, of Minnesota's 80% overall vaccination rate for nursing home staff. "We believe there is a higher number that have either been vaccinated or received an exemption."
Cullen says her research shows many low-vaccinated facilities in the state entered inaccurate data, and that skewed state data downward overall.
"I feel pretty confident that we're near the top of the class when it comes to vaccinations," she said.
As a result of this discrepancy, it's not clear how many Minnesota nursing home employees could face termination due to the looming deadline.
At the high end, there are roughly 40,000 nursing home workers in Minnesota, according to Cullen. If, as Centers for Medicare & Medicaid Services states, 20% of that group is not vaccinated, that would mean 8,000 Minnesota nursing home workers must either obtain a medical or religious exclusion or become vaccinated in the coming weeks.
Cullen counters that federal percentages lag real vaccination numbers in each state by two weeks, and do not reflect the number of those who have received a religious or medical exemption.
She said a recent Care Providers survey estimated that 6% of state nursing homes are concerned they will not meet the threshold, meaning the number of facilities in the state that will not get to 80% on Thursday is "under 10%."
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There are roughly 360 care homes in Minnesota, Cullen said. "Of that group, there are maybe 30 to 35 that may have issues on Jan. 27, (where) they are going to be struggling to get to at least that 80% threshold," she said.
With the average facility having roughly 100 employees, "if they have 15 or 20 of their employees who aren't vaccinated, it really is a couple hundred (workers let go) total ... that would be our guess."
"We've been supportive of vaccination in our settings because we know it makes a difference," she said. "The only concern right now is that our workforce is so strapped that even one or two staff having to leave puts us in a real staffing crisis."
Religious exemption means more PPE
Nursing homes are now using federal legal guidance to determine religious exemptions.
"You can't just approve everyone because they are coming," Cullen said. "If everyone has the same exemption language you want to question it."
Cullen adds that those staff who do get exemptions and are not vaccinated will have to wear a greater level of PPE.
"They will have to wear N-95s all day. They will have to be tested ... Just because someone is exempted, doesn't mean the facility doesn't have to do something to shore up infection control practices."
