Moniqua Acosta, Landis Homes' director of volunteer services

Moniqua Acosta, Landis Homes' director of volunteer services, is among roughly 150 nursing home staff in Manheim Borough to receive the COVID vaccine on Monday, Dec. 28, 2020.

Roughly six months after Pennsylvania nursing home workers first rolled up their sleeves, COVID-19 vaccination rates remain stubbornly low in Lancaster County. This is despite a recent federal survey showing an average 7% bump in staff vaccinations.

Among the county’s 32 nursing homes, the average staff vaccination rate in mid-April was 48%. By the end of June, it was 55%.

Pennsylvania saw the same 7% incremental boost in staff vaccinations, with the average rate increasing from 50% to 57% over the same time period.

“It is not safe for residents to be in homes with these kinds of rates,” Charlene Harrington, a University of California at San Francisco professor emeritus of sociology and nursing, said in an email.

  • See a list of the percentage of staff and residents vaccinated at Lancaster County's 32 nursing homes at the end of this article.

Vaccination surveys from the Pennsylvania Department of Health and the Centers for Medicare & Medicaid Services have been criticized for the slow release of flawed, self-reported data that is cumbersome to understand as it requires the public to be comfortable with spreadsheets.

Officials in at least two facilities — the Pennsylvania Soldiers and Sailors Home in Erie and the Brethren Village Retirement Community in Lititz — said the state data did not match what they reported.

When releasing its vaccination survey in April, the state health department acknowledged the report contained errors saying facility “data was reported in aggregate form and not verified.”

‘Easy data point to track’

Easy access to this vaccination data for families making placement decisions remains a challenge.

Medicare’s Nursing Home Compare website — which provides hotel-like star ratings on inspections, staffing and quality of care for consumers to compare facilities — does not include COVID-19 vaccination rates.

Nursing home vaccination rates have not always been available.

Because of this dearth of information, LNP | LancasterOnline sought data on nursing home vaccination rates in a March 10 Right-to-Know request, only to discover in the appeal process — after a denial — that the state health department doesn’t track this.

For months, consumers had no vaccination information to aid in deciding which homes were keeping the virus at bay.

“That’s a pretty bright and easy data point to track,” said Sam Brooks, a Philadelphia attorney, who is program and policy manager for the National Consumer Voice for Long Term Living.

The state health department released its first and only vaccination survey on April 15 and the Centers for Medicare & Medicaid Services did so on June 10.

Brooks, a longtime advocate for Pennsylvania nursing home residents, added, “I think, unfortunately, that our overall response to COVID in nursing homes has been reactionary.”

‘Feeding the fourth wave’

Staff vaccination rates are a critical measure of patient safety in the pandemic because the virus penetrated congregate settings largely through infected employees.

Staff cases represent nearly 20% of the infections in long-term care facilities.

With a more contagious and possibly more dangerous variant strain ravaging unvaccinated communities, the COVID-19 vaccines continue to be the best defense against severe illness and death.

And yet, facilities have struggled to raise staff vaccination rates in nursing homes, widely considered ground zero for COVID-19.

Marty Kardon, a Philadelphia attorney representing about a dozen families of residents who contracted and died of COVID-19 at the Gardens at Stevens last fall, called the low staff vaccination rates shocking.

“This kind of conduct is feeding the fourth wave,” Kardon said.

While staff vaccination rates did — on average — nudge up 7%, not all Lancaster County nursing homes saw increases.

Take the Gardens, an 82-bed facility in Denver Borough. Its staff vaccination rate dropped roughly 5% between April and June, according to state and federal data.

The Gardens is hardly alone.

Roughly one in five nursing homes in the county reported a drop in staff vaccination rates.

“There is no vaccine for poor care, but there is a vaccine for COVID,” Brooks said.

‘A survey? I don’t get it.’

Over both surveys, residents were vaccinated at far higher rates than staff.

In the April survey, 84% of Lancaster County nursing home residents were vaccinated. By June, the percentage had crept up to 89%, a 5% increase. Across Pennsylvania, resident vaccination rates inched up 4% from 77% in April to 81% in June.

This is not entirely surprising given residents in long-term care facilities, which includes nursing homes, have borne the brunt of the COVID-19 causalities. Residents account for 6% of all infections in Pennsylvania, but 48% of the deaths.

About a third of the county’s nursing homes reported a 10% or better increase.

A comparison of state and federal data shows Lakeside at Willow Valley in Willow Street and Calvary Fellowship Homes in Lancaster reported the greatest increases in staff vaccinations over the two months at 33% and 21%, respectively.

Landis Homes in Lititz improved its staff vaccination rates with a three-prong approach: conversations, appointments and science. Landis saw a roughly 8% increase, although, it, too, disputed some of the reported figures.

“By getting vaccinated we’re not just protecting the residents but each other, and by doing that we’re also protecting residents,” said Jenny Sheckells, Landis’ director of risk management and compliance.

Initially, vaccination data nationally was shielded from release.

The Centers for Disease Control and Prevention provided LNP | LancasterOnline a redacted spreadsheet with no dates or facility names in response to a Freedom of Information Request in March.

While some information is better than none — advocates say — an error-riddled, self-reported survey buried on a Centers for Medicare & Medicaid Services data page geared for researchers doesn’t really give families the information they need.

“I don’t think there’s any really good data anyway,” said Diane Menio, executive director of the Center for Advocacy for the Rights & Interests of the Elderly in Philadelphia.

Menio added, “I mean a survey? I don’t get it.”

What to Read Next