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Vaccine mandate could complicate Butler County nursing home staffing issues

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The Butler County Care Facility continues to struggle to find workers despite a raise in union wages as several management positions remain open, and the new federal vaccination mandate could complicate matters.

The county has spent about $554,000 this year on contracted front-line workers to man the county-owned nursing home. The commissioners have had a contract with Professional Review Network Inc. for a facility administrator and this week agreed to extend the contract on a month-to-month basis, it included an $85 per hour increase up to $200.

The county has paid $72,930 for the temporary administrator. Last year during the height of pandemic when vacancies soared the home paid $1.24 million for temporary workers.

The top job at the county-run nursing home — which pays between $84,223 and $124,800 — has been vacant since former administrator Chamika Poole resigned last October. County Administrator Judi Boyko told the Journal-News the hourly increase was included because Professional Review Network was “grossly undercompensated” under the previous agreement.

She needed a new month-to-month agreement in case she finds a new administrator soon.

“The county is continuously seeking candidates and evaluating qualifications for compatibility at the facility. Based on the greater market of health care candidates have been few and far between,” Boyko said. “I thought I had identified a candidate but terms couldn’t be reached.”

The director of nursing also recently quit and they have posted that position. Human Resources Director Laurie Murphy said there are 4 to 5 vacant nursing positions and 10 to 12 openings for front-line workers. She said they are hoping the pay raise in the recently negotiated union contract — from $13.35 to $15 per hour — plus generous county benefits will help them attract more job candidates.

“There remains an overall shortage of clinical workers in the healthcare field and the hiring challenges we face are not unique to the Care Facility,” Murphy said. “The global impact of the pandemic and recent uptake in the Delta variant cases continues to impact hiring and retention across the entire healthcare industry.”

The assistant nursing director and assistant business office manager positions are also open. Boyko said they are holding off on filling those jobs because the daily census of patients has dropped to less than half capacity at around 50 in the 109-bed facility. Because of strict nursing home restrictions during the pandemic, families were choosing to remove their loved ones from congregate care.

“Since the census now has been below 50 we’ve been maintaining that just from a business operations and funding perspective,” Boyko said. “Definitely we will replace the director of nursing and we’ll just continue to monitor to see if there is a void without an assistant director of nursing and assistant business office manager.”

Adding to existing staffing issues, President Joe Biden has tied Medicaid funding to mandatory vaccinations for nursing home employees. The county home’s main source of revenue is reimbursement from Medicaid for patient care. Murphy said it is too soon to predict the impact of the new directive.

“The mandate was just reported yesterday and the actual regulation has not been issued,” Murphy said. “We will certainly continue to monitor the impact of the mandate and its implications on county operations at the Care Facility.”

Commissioner Don Dixon, who is in the elderly care field, said he personally thinks it’s a good idea but believes it could cause a “whole lot of problems.”

Commissioner T.C. Rogers said he is also concerned about the mandate’s impact on the Care Facility, especially with what is going on in the area where hospitals have already mandated vaccines for their employees.

“I’m also concerned about all of our hospitals which have made vaccinations mandatory for their medical staff and doctors have told me that they’re short-handed now,” Rogers said. “Yeah I’m concerned.”