Pa. orders nursing homes to tally virus shot rates
One month after the state declared nearly every long-term care facility in Pennsylvania had held at least two COVID-19 vaccine clinics, the state still does not know what the vaccination rates are among staff and residents in nursing, personal care and assisted living homes, where COVID19 has caused more than 12,000 deaths.
Coming amid reports of some facilities with only 20% to 30% of their staff getting vaccinated, advocates say the state’s failure to report the vaccination rates to date potentially puts prospective residents and visiting family members — who may not be vaccinated yet — at risk of infection.
But a new order by the state Department of Health will attempt to finally answer the question of how the state’s nursing homes are doing on vaccinations — though it does not affect about 1,200 personal care and assisted living homes.
The order — quietly issued Wednesday without the state holding a news conference to answer questions about it — requires the state’s nearly 700 nursing homes to tell the state by Wednesday how many of its residents and staff have been vaccinated.
Acting state Health Secretary Alison Beam said in a news release that the goal of the “survey” to nursing homes is to help the state “effectively manage vaccine supply for all current and future residents and staff” so the state can figure out where it needs to do more vaccination clinics.
In an email answer to questions, state Department of Health spokeswoman Maggi Barton said the state plans to make the vaccination rates public for each facility, like it
has with weekly reports on COVID-19 cases and deaths since May, though it did not know when that would be.
The Pittsburgh Post-Gazette has been trying for three weeks to get at least a statewide figure on vaccination rates for long-term care facilities, but the state has been unable to provide such a figure. Though the state had the raw data of the number of doses administered in the homes, it could not say definitively how many residents and staff were working in the homes when the doses were given.
The Pennsylvania Health Care Association, which advocates for the state’s forprofit long term care facilities, told the Post-Gazette that the federal Centers for Disease Control and Prevention told it that, as of early February in the state’s nursing homes, 94.5% of residents and 58% of staff had gotten at least one dose.
This week, the CDC updated those numbers, telling the Post-Gazette that, as of Feb. 19, the vaccination rate among the state’s nursing homes had risen slightly among residents to 95.4% and more sharply among staff to 66.9%.
However, those figures do not include about 10% of the state’s nursing homes because 29 nursing homes across the state did not participate in the federal partnership program, while 46 other homes are located in Philadelphia, which is counted separately.
The CDC also did not have any data on the state’s personal care and assisted living homes, which endured a horrific surge in cases and deaths starting in November that nearly tripled the number of deaths in just four months, much like nursing homes experienced earlier in the pandemic.
It is because of how deadly the outbreaks have been among the vulnerable elderly in long-term care facilities here — something that state and congressional Republicans have increased their criticism of recently — that advocates say the state should have been collecting and publicly releasing the data on vaccination rates all along.
“This is the worst public health crisis of our time, and it’s critical that we get all of this information as soon as possible,” said Diane Menio, executive director for the Center of Advocacy of the Rights & Interests of the Elderly, an advocacy group based in Philadelphia. “We need to shape our policy around this information.”
It is part of a yearlong frustration with data on the pandemic that many advocates have had with the state.
“We’ve been asking for better data all along,” Ms. Menio said.
Pam Walz, supervising attorney for Community Legal Services, a Philadelphia nonprofit that advocates for
seniors, said the state should have collected the data from the partners in the Federal Pharmacy Partnership — pharmacies CVS and Walgreens — which oversaw vaccinations in long-term care facilities.
“It would have been good if they got the data when the partnership was administering the vaccine,” she said.
Philadelphia, which has a separate vaccination agreement from the state, did collect the data and knows what the vaccination rates are in its long-term care facilities, Ms. Walz said.
One reason the state may be asking for vaccination rates now is the result of the March 10 guidance from the federal Centers for Medicare and Medicaid Services that allowed nursing homes to open up to visitors again after months in lockdown. One reason, the guidance says, that a facility should not let visitors inis if the nursing home is in a county where more than 10% of COVID-19 tests are positive and less than 70% of the residents in a home have been fully vaccinated.
There are multiple reasons why the public would want to know vaccinations rates, particularly families.
“If you could see that 90% of the staff [in a home] is already vaccinated, that might make you feel more comfortable about visiting,”
Ms. Menio said.
Ms. Walz added: “I think it would be important for prospective residents to know the vaccination rates, too.”
Both Ms. Menio and Ms. Walz said the data is just as important for the public to have for personal care and assisted living homes as it is for nursing homes.
However, the state’s Department of Human Services, which oversees personal care and assisted living homes (which generally care for healthier, more mobile residents than nursing homes), has not issued a similar order forthose homes to report their vaccination rates.
Though DHS is collecting data on doses administered in the homes, “At this time, facilities are not required to report this data to the department, though that may change by issuing an order in the future,” department spokeswoman Erin James saidin an email.
Several administrators for personal care homes in southwestern Pennsylvania said last month in interviews with the Post-Gazette that though more than 90% of residents in their homes eagerly took the vaccine, they had difficulty getting staff to do the same.
“All of our residents got the vaccine except one,” said Cathy Himes, administrator at Grace Manor at North Park, a personal care home
with 25 residents and 25 staff. “But our staff didn’t have as high a turnout.”
Ms. Himes said only a quarter of her staff got the vaccine during the first clinic in early February, including herself.
“I’m not a person who likes shots,” she said. “But I felt obligated. I wanted to demonstrate to the staff that you should.”
She said staff who did not want to get the vaccine were a mix of the “young and invincible” and those who had skepticism about the vaccine because “there wasn’t a lot of research on it” or because they heard that some people who got it got sick or even got COVID-19 anyway.
“I hope more get it in the next clinic,” she said.
Ms. Himes did not return messages this week asking how many more staff members got the vaccine in later vaccination clinics.
But her experience was similar in other homes in the region.
Wendy Mildner, administrator at The Sheridan at Bethel Park, a personal care home with 100 residents and 150 staff, said nearly all of the residents but only about 60% of her staff got the vaccine at their first clinic in early February.
“Our goal is 75%,” she said. “Some still need to be encouraged and educated.”
Ms. Mildner, who also took the vaccine hoping to serve “as an example” to her staff, did not return calls this week asking how many more staff got the vaccine at later clinics.
But she said then that the main reasons she heard for not taking it were that “it was a live virus; that some young women worried about it affecting reproduction; others wanted to see if the rest of us had a reaction.”
“It’s a little frustrating,” she said. “But being mean and aggressive isn’t going to get them to go. We have to educate.”