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Can long-term care employers require staff members to be vaccinated?

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For much of the winter, Meryl Gordon worried about the people caring for her 95-year-old mother, who was rehabbing in a Manhattan nursing home after surgery for a broken hip.

“Every week they sent out a note to families about how many staff members had positive Covid tests,” said Ms. Gordon, a biographer and professor at New York University. “It was a source of tremendous anxiety.”

Ms. Gordon feels reassured now that her mother is fully vaccinated and has returned to her assisted living facility. But what about the two home care aides who help her 98-year-old father, David, in his Upper West Side apartment?

Neither has agreed to be vaccinated. David Gordon’s doctor has advised him to delay vaccination himself because of his past allergic reactions.

Ms. Gordon has not insisted that the caregivers receive vaccinations. “You’re reluctant to do something that could cause you to lose the people you rely on,” she said. But she remains uneasy.

It’s a question that many long-term care employers, from individual families to big national companies, are confronting as vaccines become more available, although not available enough: In a pandemic, can they require vaccination for those who care for very vulnerable older adults? Should they?

Some employers aren’t waiting. Atria Senior Living, one of the nation’s largest assisted living chains, has announced that by May 1 all staff members must be fully vaccinated.

Silverado, a small chain of dementia care homes, most on the West Coast, mandated vaccination by March 1. Juniper Communities, which operates 22 facilities in four states, has also adopted a mandate.

“We felt it was the best way to protect people, not just our residents but our team members and their families,” said Lynne Katzmann, Juniper’s chief executive. Of the company’s nearly 1,300 employees, “about 30 individuals have self-terminated” because of the vaccination requirement, she reported.

Juniper’s experience supports what public health experts have said for years: Vaccine mandates, like those that many health care organizations have established for the flu vaccine, remain contentious — but they do increase vaccination rates. As of Feb. 25, 97.7 percent of Juniper residents had received two vaccine doses, and so had 96 percent of its staff members.

That stands in stark contrast to staff vaccinations in many facilities. The Centers for Disease Control and Prevention has reported that during the first month of vaccine clinics in nursing homes, only 37.5 percent of staff members received the first shot, along with 77.8 percent of residents.


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