Kansas nursing homes fall short of staff vaccination goal as COVID-19 outbreaks continue

Jason Tidd
Topeka Capital-Journal
Brighton Place North, 1301 N.E. Jefferson St., has the best staff COVID-19 vaccination rate of any of the 15 Topeka long-term care facilities listed in data reported by the Centers for Medicare and Medicaid Services.

As state officials continue to identify coronavirus outbreaks at nursing homes, only about 10% of federally regulated long-term care facilities in Kansas have met the industry's staff vaccination goal.

The Centers for Medicare & Medicaid Services requires long-term care facilities to report vaccination rates for residents and staff. The industry's goal is to have at least 75% of staff vaccinated.

Of the 324 facilities in Kansas on the CMS list, only 34 have met the goal. Of the 15 long-term care facilities in Topeka on the CMS list, only three have met the goal.

"We should have that goal for all of society," said Debra Harmon Zehr, president and CEO of LeadingAge Kansas, "because we have vulnerable people in our adult care homes and in our society that, should they contract COVID-19 and this new variant, which is very dangerous, their chances of getting seriously ill or dying is significant.

"So getting a vaccine for the greater good of your neighbors, your family members, your friends is one of the reasons that many people get vaccinated."

The most recent data available from the Centers for Medicare & Medicaid Services has reported vaccination rates as of June 27. A searchable database of Kansas long-term care facilities is available below.

The CMS data doesn't show the full picture of nursing home vaccination rates in Kansas, since many facilities aren't regulated by the federal government.

The Kansas Department for Aging and Disability Services oversees more than 800 facilities in a variety of settings, including 476 that are state-licensed only, said agency spokesperson Cara Sloan-Ramos. Vaccination data on those facilities isn't available from KDADS.

Kansas nursing homes still having outbreaks

In February, industry organizations LeadingAge and the American Health Care Association and National Center for Assisted Living set a nationwide goal of getting 75% of senior living facilities staff vaccinated by June 30.

Mark Parkinson, the president and CEO of AHCA/NCAL and a former Kansas governor, said at the time that vaccinations have reduced the number of COVID-19 cases at nursing homes.

But Kansas nursing homes continue to experience deadly coronavirus outbreaks.

As of Wednesday, the Kansas Department of Health and Environment reported nine active clusters at long-term care facilities, with 51 cases, nine hospitalizations and three deaths.

More:Vaccination rate slows, is blamed for COVID-19 clusters at nursing homes

The KDHE has reported a total of 716 clusters at long-term care facilities in the state. Those outbreaks have directly infected 15,541 people, hospitalized 1,366 and killed 2,009. There were three new outbreaks and four more deaths reported in the past week.

More than a third of the 5,196 COVID-19 deaths in Kansas were connected to an outbreak at a long-term care facility.

​Employers may implement vaccine requirements, but Zehr said she knows of no adult care home in Kansas with such a mandate.

"That's kind of a thorny issue, it's a dilemma," she said. "There is a massive workforce shortage in adult care homes, so if you put in requirements that could deter people from working in nursing homes, or make them think, 'Well, I don't think I'm going to work here if this is going to be mandated,' then you have negatively impacted worker numbers and quality of care. That is a risk."

Not only are the state's facilities lagging behind the industry vaccination goal, but they're also in the bottom half of states.

Of all Kansas facilities reporting vaccination data to CMS, an average of 55% of staff members have been fully vaccinated. That rate ranks 19th worst of the 50 states, Washington D.C., Puerto Rico, Guam.

Residents in Kansas facilities vaccinated at higher rate

Kansas facilities have been better about vaccinating their residents, with a statewide average of 85% of residents fully vaccinated. That ranks 15th best of 53.

Zehr said a poll of LeadingAge Kansas membership found that an average of 50%-60% of staff have been vaccinated at those facilities.

"The staff vaccination rate in any adult care home is pretty reflective of the vaccination rate of the community in which it is located," Zehr said. "So if you have a relatively low vaccination rate in a county or in a city, you are going to find in fact that translates to lower vaccination rates in the nursing home or adult care home in that town or county.

"Adult care home staff are choosing not to get vaccinated largely for the same reasons that people out in the general public are choosing not to be vaccinated."

Zehr pointed to misconceptions about vaccination risk among pregnant people as a particular point to address with nursing home staff. More generally, the top reasons for vaccine hesitancy and rejection are distrust of the government and doubting the safety of the vaccine.

But staff vaccination rates range even within the capital city, from lows in the 20s to a high of 95% at Brighton Place North.

"That is very high," Zehr said. "They need a gold star, that staff team does."

David Gifford, chief medical officer of AHCA/NCAL, said in a June 30 news release that more work needs to be done on increasing the number of nursing home staff members who are vaccinated.

"Vaccination rates among long-term care staff continue to mirror other health care settings and general population rates, especially in certain parts of the country, because there continues to be a large amount of misinformation circulating around these safe and effective vaccines," Gifford said. "Ongoing vaccine education and outreach is critical in protecting our vulnerable population from COVID-19, and we remain focused on sharing credible information through our #GetVaccinated campaign.

"We are steadfast in achieving our goal to have 75 percent of staff vaccinated, and meanwhile, we must continue to be vigilant against this virus and ensure we are doing everything necessary to protect those in our care."

Reporting requirement helps ID where resources should go

Strategies from the AHCA/NCAL for increasing uptake include emphasizing benefits of vaccination while listening to concerns.

The Centers for Medicare & Medicaid Services announced the vaccine reporting requirement on May 11, along with mandates that facilities provide vaccines to their residents and staff and educate them about "the benefits and potential side effects."

The rule requires federally regulated long-term care facilities to report weekly COVID-19 vaccination status statistics for both residents and staff.

"The new vaccination reporting requirement will not only assist in monitoring uptake amongst residents and staff but will also aid in identifying facilities that may be in need of additional resources and/or assistance to respond to the COVID-19 pandemic," CMS officials said in a news release.

The rules for COVID-19 vaccines align with existing requirements for influenza and pneumococcal vaccines in long-term care facilities.

The vaccine rules are designed to help nursing home residents, who have been disproportionately affected by the coronavirus pandemic, said Lee Fleisher, CMS chief medical officer and director of CMS’ Center for Clinical Standards and Quality.

"These new requirements reinforce CMS’ commitment of ensuring equitable vaccine access for Medicare and Medicaid beneficiaries. ... Our goal is to increase COVID-19 vaccine confidence and acceptance among these individuals and the staff who serve them," Fleisher said in a May 11 statement.