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What nursing homes have been like with the spread of omicron


The Supreme Court's ruling today on the Biden administration's COVID vaccine mandates is a mixed decision. The court struck down the mandate for large workplaces but upheld the mandate for health care facilities that receive federal funds like Medicare payments. In effect, this applies to almost every hospital and nursing home in the U.S.

NPR health correspondent Rhitu Chatterjee joins us now to talk more about nursing homes, which, like hospitals, have been battered by the omicron surge. Hey, Rhitu.


CHANG: Hi. So, you know, I remember how badly nursing homes were hit early on during the pandemic. Can you just tell us, how are they faring today?

CHATTERJEE: So well, just last week, there were 32,000 infections among residents, slightly lower than the huge peak reached last winter. But the good news here, Ailsa, is that the deaths are only about a tenth of what they were last winter, so vaccines are really helping.

But the staff, though, is a whole different story. I spoke with Mark Parkinson. He leads the trade group that represents for-profit nursing homes and assisted living.

MARK PARKINSON: Unfortunately, we are now at an all-time high in terms of staff cases. In the last week, there were over 50,000 cases of staff that reported positive from COVID.

CHATTERJEE: And many of those people died. Last week alone, almost 70 nursing home workers died, which is close to the record number of staff deaths in the very first summer of the pandemic.

CHANG: Wow. Wait. Why is the death rate so high among nursing home workers?

CHATTERJEE: Well, it really comes down to lower vaccination rates compared to residents. And that's why the Supreme Court ruling upholding a national vaccine mandate in health care workers is going to be crucial - because nursing home staff were much slower to get vaccinated than residents. They've caught up somewhat, but there's still a huge gap when it comes to boosters. Only a third of workers are boosted.

Mark Parkinson from the industry group says vaccine hesitancy is a big problem.

PARKINSON: You get into the rural areas. You get into the more red states like my home state of Kansas, and you just run into that same vaccine hesitancy that you see in the general population - a lot of misunderstanding, confusion, people that have been misled by false claims on the internet.

CHATTERJEE: So while the Supreme Court was considering the mandate, many nursing homes did put in place their own vaccine mandates. But many others didn't.

CHANG: Well, I mean, with so many workers getting sick and dying, I can imagine that that has really had an impact on care for residents at these nursing homes.

CHATTERJEE: Yeah, it's worsened an already bad situation. More than 200,000 people have quit their jobs at long-term care facilities since the start of the pandemic because of the burnout, and many of these jobs pay very little. And these days, you can make more money doing something else.

Laurie Brewer is the long-term care ombudsman in the state of New Jersey. She says this is affecting care.

LAURIE BREWER: We are certainly seeing a huge increase in the number of calls from residents who are saying that they are not being changed. They're not receiving their meals on time.

CHATTERJEE: And many facilities have shut down. Many are not accepting new patients, which, in turn, affects hospitals because now they can't discharge the patients who need to go into long-term care.

Here's Dr. David Kim at Providence, which has hospitals along the west coast.

DAVID KIM: It starts backing up all along the chain, and then you start seeing it come out, you know, with long wait times in the ER, patients in hallways waiting for rooms because they're not ready to go home, but they can't get a bed.

CHATTERJEE: And the ripple effects are everywhere really because now there's more pressure on families who have - now have to take care of elderly loved ones...

CHANG: Yeah.

CHATTERJEE: ...Because they can't be placed in long-term care.

CHANG: That is NPR's Rhitu Chatterjee. Thank you, Rhitu.

CHATTERJEE: Thank you. Transcript provided by NPR, Copyright NPR.

Rhitu Chatterjee is a health correspondent with NPR, with a focus on mental health. In addition to writing about the latest developments in psychology and psychiatry, she reports on the prevalence of different mental illnesses and new developments in treatments.