When the word “hero”, is used to describe an individual, it generally encompasses a wide-array of positive attributes such as courage, selflessness, mental fortitude, and strength of character. In our own lives, we may consider someone we personally know to be a hero, or we may view a public figure, whether from the past or present, as a hero.
The word “hero” has been used a lot over the course of the past eighteen-months by the corporate media, by the corporate advertisers, and, by the federal government in referring to people in various occupations who have weathered a panoply of challenges, yet continue to work diligently through this pandemic era.
Among the frontline workers who have been labeled as heroes are those individuals who work in nursing homes. It is without question that the employees of nursing homes in the nation, many of whom have fast-paced, stressful jobs, have been under a great deal of increased emotional strain during this pandemic. Working in such a facility presents unique and difficult challenges during this time, including mental and physical fatigue exacted from long hours combined with trauma arising from loss of life of residents and co-workers. A rise in COVID-19 cases in the surrounding community, or, a breakout internally in such a facility, presents another layer of issues, including potential staffing shortages, whether short-term or long-term. And, as the nation has been grappling with the pandemic for more than a year and a half, there are many localities in the country that are suffering shortages in nursing-home staff.
Against this backdrop, President Biden announced last week that his administration is developing new regulations which will mandate that nursing homes require that all of their workers be fully vaccinated against COVID-19 in order for the facility to participate in Medicaid and Medicare programs. This directive by the President is troubling because it shows an utter lack of concern for the nursing home staffing shortages in certain localities; it also demonstrates a failure to take into account the potentially perilous future of individual nursing homes and the lives of the individuals who will most likely be affected by staffing shortages – the residents.
According to an AARP analysis of federally-certified nursing homes, more than forty-percent of nursing home workers nationally were not fully vaccinated as of this July. (Source: 4 in 5 Nursing Homes Behind on Staff Vaccination Goal, Analysis Finds, by Emily Paulin, AARP, updated July 19, 2021.) According to the AARP Nursing Home Covid-19 dashboard, as of August 12, 2021, there are a number of states where the vaccinated nursing home staff percentage is under fifty-percent, including Florida (45.1%) and Louisiana (44%). (Source: AARP Nursing Home Covid-19 Dashboard, AARP Public Policy Institute, updated August 12, 2021).
Having visited numerous relatives and friends in nursing homes in different states over the years, I have always been impressed with the work-ethic of the nursing-home worker, particularly the front-line certified nursing assistants who go about their challenging jobs with smiles and patience, treating the residents with kindness and respect as if they were their own family members. The CNA occupation in a nursing-home environment is generally considered to be one that is physically and emotionally taxing, yet low-paying. It is the CNA and the other staff members, such as the receptionist, the maintenance worker, the activity director, and, the nurse, who make a difference in the daily lives of those who are in nursing-home facilities. Nursing-home workers are the individuals who have continued working through the pandemic over these many months – even during the months prior to vaccine availability – selflessly caring for the residents or providing support for the operations of the facility. These are the heroes that we have been told about for the past eighteen-months. But now, under Joe Biden’s directive, these heroes will essentially be divided into two groups: the fully-vaccinated nursing home employee and the unvaccinated former nursing home employee. The nursing home worker-hero who is unvaccinated will be stripped of their hero status and now become a zero: as in zero nursing-home employment.
Now, in announcing the formulation of this regulation, one would hope that the President and his team are convinced that this is the best course of action to protect nursing-home residents and employees from the Coronavirus. But, there are a number of concerns that arise from President Biden’s decision. For example, what happens during a pandemic, when there are already employee shortages in nursing homes in some areas of the country, and a significant portion of a nursing home’s workforce, comprised of unvaccinated staff members, quits or gets fired as a direct result of this regulation? Whether a nursing home loses fifteen percent or twenty percent or some other percent of its staff, will it be able to operate without significant interruption and without negatively impacting its residents? And, if an employee shortage worsens in an area of the country where it is already challenging for a nursing home to find qualified staff, will the nursing home be unable to attend to its vulnerable residents’ immediate needs? Will fully-vaccinated staff members, who may have to pick up extra hours and shifts due to a sharp decrease in staff, leave the nursing-home workplace and seek job opportunities with less demands?
Judging from President Biden’s handling of the situation in Afghanistan, and his public addresses on that topic, perhaps he has not analyzed all of the data to assess potential critical staffing shortages and operational problems that may arise in nursing homes as a result of his planned course of action. Unfortunately, if Mr. Biden’s failed deliberation, failed planning, and failed implementation in regard to the Afghanistan situation is any indication, we have a lot to be concerned about in regard to the future of nursing-home care in the nation.