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How two Minnesota long-term care organizations are using mandates to get all their workers vaccinated

Workers at Episcopal Homes in St. Paul and Eventide in Moorhead are required to be vaccinated this fall.

photo of sign outside episcopal homes
When St. Paul’s Episcopal Homes adopted its vaccine mandate for staff, 80 percent of its 550 workers were already vaccinated.
MinnPost photo by Greta Kaul

In late July, Episcopal Homes, along University Avenue in St. Paul, announced it would require its staff to be vaccinated against COVID-19 starting Sept. 1. Episcopal Homes was one of the first long-term care communities in Minnesota to make such a requirement.

At the time, 80 percent of the facility’s employees in independent living, transitional care, assisted living and two nursing homes were vaccinated, but the growing threat of the more severe and more readily spread delta variant convinced leaders of the facilities to require the vaccinations in an effort to get those numbers closer to 100 percent.

As the deadline to get vaccinated draws near at both Episcopal Homes and Eventide Senior Living Communities, a long-term care organization with locations in western Minnesota and North Dakota that’s requiring staff to be vaccinated before Oct. 1 — and as more employers in Minnesota mandate COVID-19 vaccination — MinnPost talked to leaders at both facilities about how things are going so far and what challenges remain in getting staff vaccinated.

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Requiring vaccines

Leading up to Episcopal Homes’ announcement of a staff vaccine mandate on July 30, President and CEO Marvin Plakut said Episcopal Homes heard a growing chorus of residents and family members pushing for a vaccine requirement at the facilities.

More than half — 59 percent — of COVID-19 deaths in Minnesota have been among residents of long-term care and assisted living facilities. Long-term care residents also endured months of lockdowns and interruptions in visitation schedules due to COVID-19 cases in facilities, leading to isolation for many residents.

“COVID has just been hell for people being able to not visit their loved ones for over a year,” Plakut said.

Despite the stakes for residents, Plakut described the decision to require vaccines as something of a risk: Long-term care facilities across the country face staffing struggles that pre-date the pandemic, and are still struggling to hire and retain staff.

photo of two staffers at episcopal homes
MinnPost photo by Greta Kaul
Melissa Schneider, administrator of Episcopal Church Home, and Marvin Plakut, CEO of Episcopal Homes
“We only have to walk 100 yards that way, and there’s our nearest competitive nursing home,” Plakut said. Plus, there’s plenty of restaurants and retail nearby.

When the decision was made to require staff vaccinations at Episcopal Homes, 80 percent of the roughly 550 staff members had been vaccinated against COVID-19, leaving 110 or so unvaccinated.

Jon Riewer, the president and CEO at Eventide, said mandating vaccination is nothing new for his company, which requires employees to be vaccinated against the flu annually unless they get an exemption. Out of a staff of 1,200, there are usually about 14 flu shot exemptions per year, he said. At their facilities, COVID-19 vaccination rates vary from more than 85 percent in Moorhead, and less some facilities in North Dakota, Riewer said.

Riewer characterized requiring the COVID-19 vaccine is the right thing to do.

“It goes beyond the individual here, we’ve got to do what’s right for the greater good and if we can’t do that, then what are we doing?” he said.

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Talking to staff

Key in getting staff on board has been educating workers about vaccinations, said Melissa Schneider, administrator of Episcopal Homes’ Church Home.

“We’ve really worked on people one by one, so [we] found out what their fears were, what their hesitations were, and then sent him the person that seemed the most appropriate to speak to those,” she said. If it was science-related, the infection preventionist talked to the staff member. If it was a cultural reason, people who could best speak to those concerns stepped in.

So far, Schneider said people who have been hesitant have typically not been resistant.

“I think we anticipated that staff would be angry, that they felt like we would be forcing something on them, but overwhelmingly it was more indifferent,” Schneider said. “A lot of the staff I talked to were just waiting on the vaccine. They were thinking about getting it, but they were wanting to see how it played out for other people.”

Riewer said conversations are a big part of persuading staff to get vaccinated at Eventide, too.

“We’re constantly having conversations with our folks that we think could be on the bubble or still processing or even struggling with the decision,” he said.

Schneider said some staff at Episcopal Homes who were hesitant to get vaccinated at the first, second, or even third clinic eventually came around as a result of seeing colleagues being vaccinated or as a result of having conversations with leadership.

At Episcopal Homes, any staffers who leave as a result of the vaccine mandate will get their paid time off paid out if they give two weeks’ notice. The facility is hosting a vaccine clinic in the coming weeks and expects to see vaccine rates increase then, though by how much remains to be seen.

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“Really it’s a moral duty that we have. And fortunately we’re at that point where we know that we can survive. Even if we lose some staff, we can manage the staffing as such, at least we believe so,” Plakut said.

Across the industry

Patti Cullen, the president and CEO of Care Providers of Minnesota, the local industry group for long-term care facilities, said other long-term care facilities, including the Good Samaritan Society have both mandated vaccines for employees.

More long-term care facilities in Minnesota and across the U.S. will soon be requiring vaccines. On Wednesday, the Biden administration announced that employees at nursing homes that receive federal funding through Medicare and Medicaid will be required to be vaccinated against COVID-19. But so far, mandates are far from widespread.

Plakut said he has no criticism for colleague organizations that aren’t mandating vaccines. Being in St. Paul means Episcopal Homes is located in an area with high vaccine acceptance rates — more than 70 percent of adults are vaccinated in Ramsey County. If staff leave as a result of the vaccine mandate, an urban community has more potential employees to pull from. It can also be a tough sell: being vaccinated means much better protection against COVID-19 for staff and residents, but everyone in the facility still has to wear PPE.

For employers considering requiring vaccines, Plakut had some advice.

“Make sure that your entire leadership team, your entire management team is in sync, make sure that everybody’s on board with it so that there are no naysayers in leadership positions,” he said. “And lead with empathy instead of judgment.”