County to weigh nursing home pay, as judge halts vaccine mandate

LACONIA — As Belknap County officials struggle to stabilize the workforce at the Council Nursing Home, the county received a reprieve from the federal COVID vaccination mandate that was threatening a further downsizing of the facility.

A federal judge on Monday blocked President Joe Biden's administration from enforcing a coronavirus vaccine mandate on thousands of health care workers in New Hampshire and nine other states, which brought the first legal challenge against the requirement.

Top administrators for the county and the nursing home have been contending with the ongoing loss of nurses staff due to low pay, a situation further aggravated by some staff who have either already quit or are threatening to do so over the mandate that they be vaccinated against COVID-19.

“That’s welcome news for the county,” Belknap County Commission Chair Peter Spanos said of the court decision which was announced by Gov. Chris Sununu early Monday afternoon.

The County Commission had been planning to hold an emergency meeting late Monday afternoon to consider possible ways to increase nursing home pay in order to stave off more staff departures. But that meeting was canceled Monday morning — prior to the announcement of the judge’s ruling — after the Nursing Home was able to hire three traveling nurses for the next three months, County Administrator Debra Shackett said.

Shackett and Nursing Home Administrator Shelley Richardson are now scheduled to present their recommendations for addressing the staffing shortage at the commission’s regular meeting set for Thursday.

Richardson has said on numerous occasions that the vaccine mandate could have resulted in a loss of staff to the extent that the nursing home would have to close down another wing, a move that would have required finding new places for 19 residents.

The regulation from the Centers for Medicare & Medicaid Services said workers were supposed to get their first dose by Dec. 6 and their second shot by Jan. 4.

Sununu said the mandate threatened the well-being of many who need nursing home care.

“This is a big win for New Hampshire’s health care system,” he said of the ruling issued by a federal judge in Missouri. “Nursing homes were at risk of closure if the Biden mandate remained in place. This helps maintain the staff New Hampshire needs to care for our loved ones.”

Spanos said the temporary ruling over the vaccine mandate gives the county some breathing room as it works to find a long-term solution to the staff crisis which has already forced the facility to reduce its capacity by one-third. The home has an operating license for 94 residents.

Shackett and Richardson have said the home has found it increasingly difficult to retain and recruit nursing staff because the pay is half to one-third what other long-term care facilities in the area offer at all levels of nursing competency. Further complicating the situation is the shortage of nurses nationwide. That has led to many health-care facilities turning increasingly to staffing agencies which provide temporary nurses who are paid considerably more than full-time staff nurses, a situation that undermines staff morale.

The options Shackett and Richardson have considered are a one-time lump payment to nursing home staff or adjusting the wage scale to raise the pay.

Shackett said the nursing home employees prefer the increase in pay rates over the one-time stipend.

She said Monday that she needed a couple more days to put a proposal together that would include hard numbers.

Spanos said that given the urgency of the situation it was unfortunate that the results of a full-scale study of wages paid to county employees will not be completed until the spring.

State Rep. Mike Sylvia, who is chair of the Belknap County Delegation, said in a letter to the editor published in Saturday’s Daily Sun that he believed granting vaccine-mandate exemptions to all nursing home employees who request one would resolve the staffing problem.

Sylvia did not respond Monday afternoon to a request to comment on the announcement of the temporary halt to the vaccine mandate.

The judge who issued the ruling seemed persuaded that the mandate could lead to staffing shortages.

“The scale falls clearly in favor of healthcare facilities operating with some unvaccinated employees, staff, trainees, students, volunteers and contractors, rather than the swift, irremediable impact of requiring healthcare facilities to choose between two undesirable choices — providing substandard care or providing no healthcare at all,” the judge wrote.

“This order means that CMS may not enforce its vaccine mandate against any facility within the State of New Hampshire until further notice,” New Hampshire Attorney General John Formella said. “We will continue to participate in this litigation and seek permanent relief.”