Missouri health officials say vaccine mandate will worsen staffing shortage at nursing homes

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JEFFERSON CITY, Mo. — Long term care facilities and nursing home staff will soon be required to be fully vaccinated under President Joe Biden’s announcement last week but some health officials in Missouri say the mandate is a bad idea. 

The Missouri Health Care Association is telling lawmakers they support vaccination but they don’t support a mandate for staff. 

“The vaccine hesitancy across the state, especially among the younger populations in our staff is something that we not been able to overcover,” executive director for the Missouri Health Care Association Nikki Strong said. “We don’t believe a straightforward mandate is the appropriate way to achieve full vaccination in our facilities.”

The association represents more than 65% of 500 nursing care facilities in the state. Strong told members of House Subcommittee on Appropriations – Health, Mental Health and Social Services Tuesday afternoon some staff is threatening to quit if the mandate is enforced. 

“She said to me, I will leave,” Strong said about an employee. “I love long term care, but I will leave long term care and I will go into another, a completely different sector.”

She said nursing facilities had extreme staff shortages before COVID-19 and has worsened since the pandemic. 

“We have lost a tremendous amount of staff due to exhaustion levels, burnout, stress, anxiety or in some cases, people that can stay home and make more money staying home than they can in our facility,” Strong said. “The facilities have to have staff. There’s nobody else to take care of them. This is 24/7 care. It has to happen.”

Biden’s announcement would require staff within Medicare and Medicaid funded facilities, like nursing homes to require staff to roll up their sleeve for the vaccine. 

According to the Centers for Medicare and Medicaid Services (CMS) only 50% of nursing home staff in Missouri is vaccinated, the third lowest in the country behind Florida and Louisiana. 

“The response I’m getting shows that the mandate rather than encouraging people to get vaccinated, has almost created more resistance,” Strong said. 

St. Louis Democratic Rep. Peter Merideth said Missourians should want safety measures in place for people taking care of the most vulnerable. 

“I’m just frustrated because it seems like a commonsense thing that if you’re working in one of these places where you have such a high risk of people dying, we should be expecting people to be vaccinated from this,” Merideth said. 

He said long term care facility staff needs to be paid more in order to help with the shortage. 

“It feels like we are focusing on the wrong thing and ultimately, it’s a conversation that could end up leaving people less safe,” Merideth said. “We don’t pay them enough to respect the work they do and so we are adding another requirement on them that might be the straw that broke the camel’s back, but the tough job that they’ve had for the last two year for the little pay, undoubtedly is a bigger factor in the staffing crisis.”

Merideth compared the staffing shortage in long term care facilities to restaurants and other small businesses across the state. 

“I don’t hear us talking about getting rid of safety requirements on them,” Merideth said. 

Strong said 85% of residents in long term care facilities across the state are vaccinated which has reduced breakouts at facilities. During the pandemic, she said nearly every state suffered a breakout. According to CMS, there were more than 3,700 COVID deaths in long term care facilities. 

An official with Missouri’s Medicaid program said they have not been in communication with the federal government about when the mandate would go into effect or if the state could apply for a waiver. 

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