COVID spread causing 'surreal' staffing problems in nursing homes

Long-term care in Minnesota is in dire need of staffing support, industry and public health leaders say. With new COVID-19 cases in the thousands and the spread continuing widely, large numbers of staff are out sick or quarantining because of exposure.

The shortages are coming at a difficult time in the pandemic.

In the last month, nearly 85 percent of skilled nursing facilities have had at least one case of COVID-19, which has meant most facilities are currently dealing with the virus, according to the Minnesota Department of Health.

The situation is forcing officials to take unusual measures to fill gaps. They plan to email thousands of state employees asking them if they would temporarily work in long-term care.

“We're trying to really turn over every stone so to speak, to think about ways to support the staffing needs across the health care continuum, but particularly in long term care, with the number of health care workers in these settings that continue to be exposed,” said Jan Malcolm, Minnesota’s health commissioner.

The commissioner went on to say her agency is working with 47 long-term care facilities that are in crisis mode when it comes to staffing.

From the beginning of the pandemic to mid-October, the Minnesota National Guard provided emergency staffing to three long-term care facilities.

In the last month, the Guard has been called out six more times and are still helping in four of those places. They are getting ready to go to two more facilities. Of those eight total calls for the National Guard most recently, seven are for care homes beyond the Twin Cities metro area.

That’s where COVID-19 cases skyrocketed in many places this fall. The Health Department says long-term care staff are most likely contracting the virus outside of work.

”Staffing has been unbelievably challenging in a lot of settings, some of mine, within our organization, but certainly throughout our industry,” said Christine Bakke, regional director of operations for St. Francis Health Services — based in Morris, Minn. — which runs 16 facilities across the state.

Bakke said that if “one or two staff members” are affected by COVID-19, “you can cover it. When you start seeing 20 to 30 percent of your workforce at the same time, that becomes almost unbearable.”

Some of St. Francis’ campuses have relied on nurses from the state emergency operations office, but they’ve not had to call in the National Guard.

“We have had scenarios across our industry where we have had to say, ‘This is not the care we want to give, we are going to give the best we can, but this is not who we are. And we are going to make sure you are fed, that you get to the bathroom, that you get your medications. And that might be the best we do today and not harm you,’” Bakke said.

“And it's sad, it is really sad that we might have to make that choice,” Bakke added.

At PioneerCare in Fergus Falls, Minn., around 20 staff members have tested positive for COVID-19 since July, with the majority reporting infections in the last two to three weeks, according to CEO Nathan Johnson. His facilities — a nursing home, assisted living and memory care units, along with independent living — haven’t needed emergency staffing, but he’s offered help to other nearby facilities who have. He said the pandemic has put an amazing strain on the industry.

“It's almost kind of hard to put it into words, because it just feels so surreal. I've been a licensed nursing home administrator for 20 years, and I've never seen anything remotely close to this,” Johnson said.

Michelle Larson, director of the Health Regulation Division at the state Health Department, says everyone, not just health care workers, needs to do whatever they can to keep from getting infected, or infecting others.

“I just really beg that people [to] think beyond themselves in terms of COVID and vulnerable people around them, and set aside their personal beliefs and really try to help us protect the public. We really need their help right now,” Larson said.

Gov. Tim Walz urged people to refrain from gathering with anyone outside your household for Thanksgiving. Health officials said even if you get a negative COVID-19 test result, you still might spread the virus to others, including older, vulnerable relatives and friends.

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