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Pa. nursing homes will need 80% of staff vaccinated to avoid testing requirement — but it’s not a mandate

Fewer than 13% of nursing homes have reached or exceeded 80% of their staff vaccinated, the department said, leaving most facilities at risk.

Only 12.5% of Pennsylvania nursing homes have at least 80% of their staff vaccinated. They were among the first to have access to the COVID-19 vaccine; pharmacist Nadine M. Mackey, left, gives a shot to a nursing home nurse in Phoenixville in December on the first day that vaccinations began in nursing homes.
Only 12.5% of Pennsylvania nursing homes have at least 80% of their staff vaccinated. They were among the first to have access to the COVID-19 vaccine; pharmacist Nadine M. Mackey, left, gives a shot to a nursing home nurse in Phoenixville in December on the first day that vaccinations began in nursing homes.Read moreJOSE F. MORENO / Staff Photographer

If Pennsylvania nursing homes don’t have at least 80% of their staff vaccinated by Oct. 1, the Department of Health announced Thursday, all employees would have to undergo regular coronavirus testing — but the Wolf administration stopped short of issuing a vaccination or testing requirement.

Less than 13% of the 700 nursing homes statewide, excluding Philadelphia, have reached or exceeded 80% of their staff vaccinated, the department said, leaving most facilities at risk for future coronavirus outbreaks.

Yet the Wolf administration called the goal only an “expectation” and did not ask nursing homes to have all employees vaccinated.

“We are committed to helping prevent outbreaks by stopping COVID-19 from entering a nursing home in the first place, and one of the best ways we can do this is through vaccinating staff in skilled nursing facilities,” Executive Deputy Health Secretary Keara Klinepeter said in a statement. She called the 80% goal “aggressive but achievable.”

Though the policy adds to the pool of Pennsylvania workers expected to get vaccinated, it is less forceful than the mandate Gov. Tom Wolf announced Tuesday that employees in state-run health-care and high-risk congregate facilities will have to be vaccinated or undergo weekly testing.

The policy represents a “minimum expectation,” Department of Health spokesperson Maggi Barton said, with facilities encouraged to set a goal of 100%. The frequency of testing at places that don’t reach 80%, as well as enforcement, will be determined closer to Oct. 1, she said.

The directive drew frustration from some in the nursing-home industry, while a separate challenge was mounted to Wolf’s mandate. In both cases, representatives said workers have needed more support from the administration during the pandemic.

States across the country have announced varying types of vaccine mandates for workers in recent days; New York, Maryland, and Virginia have set mandates for all state employees. Philadelphia on Wednesday announced that all city employees will need to be vaccinated or wear two masks at work starting Sept. 1.

New Jersey is set to implement a vaccine-or-test mandate for health-care workers, which includes those who work in long-term care homes. Employees who don’t get vaccinated will have to get tested once a week at minimum.

» READ MORE: As cases rise, so do new rules: Philly adds a mask mandate, Pa. to require vaccination or tests for some workers

Mixed reactions

Though case rates have remained low in most nursing homes since vaccines became available, getting all workers vaccinated has been a challenge. By April, only about half of those in Pennsylvania said they had been immunized. Last month, CDC data indicated that low vaccination rates among staff in nursing homes could be linked to an increase in infections at the facilities, the Associated Press reported.

Pennsylvania’s reported cases among long-term care facility residents have increased slightly since mid-July, according to state data, but remain far lower than during the pandemic’s peaks. However, rising case rates outside the facilities as a result of the delta variant are a concern: The level of community spread was found early in the pandemic to be directly tied to spread inside nursing-home facilities.

More than 13,400 residents and employees in nursing and personal care homes in the commonwealth, excluding Philadelphia, have died of the virus since the pandemic began. Cases have been confirmed for more than 88,000 in the hard-hit facilities, according to state data.

The Department of Health will begin publishing vaccination numbers for the state’s nursing homes on a new dashboard on its website, using self-reported data that the federal government collects weekly.

“We want families to see the vaccination rates where their loved ones are living and working,” said Klinepeter. “If you don’t like what you see, contact the facility and encourage them to take the necessary steps to increase staff vaccination rates to keep COVID-19 out.”

Accessing the data has been an issue across the country. In Pennsylvania, reporters and advocates had requested results of a facility survey for months before the state released it.

Of the nursing homes in Southeastern Pennsylvania, 36 had reached the threshold as of Aug. 1, according to federal data, with an additional 42 facilities in the 70% range.

The policy drew mixed reactions.

Philadelphia nursing-home consultant David Hoffman said it did not go far enough, saying vaccination should be mandatory. Not requiring vaccination means nursing-home management is “recklessly endangering the residents,” he said.

The Pennsylvania Health Care Association, a trade group for nursing homes, said the policy should have come with solutions to help facilities achieve the goal. Zach Shamberg, president and CEO, said PHCA, its members, and their workers were not consulted.

“Providers and workers are going to view this as a threat, and we don’t believe that that’s going to increase acceptance rates,” he said.

He noted that nursing-home workers are already tested monthly, weekly, or biweekly depending on the local spread of the virus.

The Department of Health will support surveillance testing for facilities that reach 80%, a spokesperson said, and those that don’t must increase testing for unvaccinated individuals at their own expense.

SEIU Healthcare PA, the state’s largest union of nursing-home workers, issued a statement supporting the Wolf administration’s move, saying the union recommends that all workers get the vaccine.

» READ MORE: City officials spent weeks preparing Philly’s latest mask mandate. Not everyone is embracing it.

Mandate challenges

The nursing-home announcement also came shortly after Wolf, speaking at a vaccine clinic in Lancaster, told private businesses to mandate the vaccine for their workers — though he has not done so for all commonwealth employees and the nursing-home policy stops short of that.

The Pennsylvania State Corrections Officers Association said Thursday it would mount a legal challenge to the state’s plan to mandate vaccines for its members.

In a letter to Wolf, president John Eckenrode said the state had not done enough to protect correctional workers or keep prisons safe. He said workers and inmates were exposed to, and in many cases infected with, the virus during the winter, when correctional employees were not yet in the category of people eligible for the vaccine and prison transfers were not suspended.

He also said the state’s policy to test unvaccinated employees weekly would not be adequate.

» READ MORE: With 13,000 infected, 100 dead of COVID-19 in Pa. prisons, advocates urge faster releases

“Your decision this week to mandate vaccinations and/or testing is a slap in the face — and, frankly, way too late because thousands of our members already have been infected, due to your inaction,” Eckenrode wrote.

Asked about the union’s letter at his news briefing in Lancaster, Wolf said he had not yet read it.

“I just heard about it,” he said. “Again, we’re trying to keep people safe.”

Staff writer Harold Brubaker contributed to this article.