Assisted living leaders urge state to mandate COVID-19 shots for workers

The state has required vaccines for nursing home workers, but skipped thousands of assisted living employees.

Maplewood at Mayflower Place, an assisted living facility, along Buck Island Road in West Yarmouth.Steve Heaslip/Cape Cod Times

Massachusetts assisted living executives, worried about the rapidly rising tide of COVID-19 infections in the state, urged the Baker administration on Thursday to mandate COVID vaccines for workers in their industry.

They say thousands of frail elders in assisted living residences, most of them vaccinated but with weak immune systems, are still vulnerable to infections because many workers in the facilities have yet to get their shots. Assisted living residents generally have more independence than those in nursing homes, but face many of the same health risks.

The Baker administration last week ordered most nursing home workers to be fully vaccinated against the coronavirus by Oct. 10. But the emergency order did not include the 270 certified assisted living residences in the state, with 16,000 residents and about 22,000 staff.

“The Baker administration made the right call by mandating vaccination of staff in skilled nursing facilities, and we want to build on this effort as partners in protecting older adults across the care continuum,” said Brian Doherty, president and chief executive of the Massachusetts Assisted Living Association.

Doherty said about 78 percent of assisted living staff and 98 percent of residents received their shots early this year when pharmacies sent vaccination teams to the state’s nursing homes and assisted living residences. It’s unclear how many staff members remain unvaccinated now.

Senior care executives have been wary of mandating vaccines company by company, fearing such a requirement would potentially cause employees to leave, exacerbating a labor shortage in the industry. But with the extremely contagious Delta strain of the virus fueling worrisome outbreaks in nursing homes, several larger assisted living companies, comprising about 30 percent of the assisted living facilities in Massachusetts, already have mandated the shots.

“We have a moral imperative and obligation to do everything we can for our residents and that means protecting them from COVID-19 with every tool we have,” said Larry Gerber, president and chief executive of EPOCH Senior Living, with nine facilities in Massachusetts and about 85 percent of its workers vaccinated.

EPOCH last week told employees they had until Oct. 15 to get their shots, and has said they will suspend workers without pay for two weeks if they miss the deadline, but will give them another chance to get vaccinated before terminating them.

Residents of assisted living facilities are largely similar to those who are in nursing homes, and the staff, including nurses aides, housekeeping, and food service, perform many of the same duties for similar pay.

But Massachusetts has a long history of regulating the industries quite differently, requiring more stringent rules for nursing homes, which the state considers health care, versus assisted living facilities, which are regulated more like private residences.

Still, the Baker administration last fall for the first time required workers in both settings to get flu shots. Complications from the flu are more common among older adults, who typically suffer from other chronic health conditions. The order aimed to avoid the confluence of flu and COVID-19, which can be deadly to older patients and swamp the health care system.

The Executive Office of Elder Affairs, which regulates assisted living residences, said in a statement that it continues to monitor COVID-19 cases in the facilities, but it did not address whether the Baker administration intends to mandate shots.

“The Commonwealth continues to work with [assisted living] owners and operators to provide opportunities for residents and staff to receive the COVID-19 vaccine, including at one of the over 900 vaccination locations across the Commonwealth,” the statement said.

Several states, including Connecticut and Washington, have recently ordered COVID vaccines for senior care settings, including assisted living facilities.

“Even small numbers of COVID-19 cases in long-term care facilities lead to increased limitations and restrictions on visits by family members, friends, and loved ones, putting at risk the emotional and social well-being of all residents,” Susan Bysiewicz, Connecticut’s lieutenant governor, wrote in her Aug. 6 executive order.

Among the Massachusetts assisted living companies that have vaccine mandates is Benchmark Senior Living, with 31 facilities in the state. Benchmark issued its mandate in May, requiring all workers to be fully vaccinated or in the process of getting the shots by the end of July.

Tom Grape, the chairman and chief executive, said Benchmark, with about 5,600 workers in seven states including Massachusetts, has only lost about a dozen workers because of the requirement.

“We worked hard to make this not a threatening thing, but to do this in collaboration with our associates,” he said, including sponsoring educational forums to help workers understand why the shots are vital.

But both Grape and Gerber, from EPOCH Senior Living, said a statewide mandate for assisted living is still sorely needed because so many smaller companies are unable to require the shots for fear of losing workers.

“What the Baker administration did with nursing homes is the right thing to do,” Grape said. “And that’s why we did it.”