Comply or eventually face the closing of the nursing home. That was the grim choice confronting Alva Hospital Authority (AHA) trustees during their meeting Tuesday, Nov. 23. Share Convalescent Home Administrator Kelly Parker presented the Mandatory Covid-19 Vaccination Policy developed for the nursing home to comply with CMS (Centers for Medicare and Medicaid Services) guidelines.

Parker defined what is meant by vaccination. Dec. 5 is the first deadline when nursing home staff must have had a single dose vaccine or the first of a two-dose series. Anyone not meeting the Dec. 5 deadline must be placed on furlough for 60 days.

A person is considered fully vaccinated two weeks after a single dose vaccine or two weeks after the second dose of the two-dose vaccine. By Jan. 4, 2022, all staff must be fully vaccinated meaning the final dose was two weeks prior.

There are two possible exemptions. A medical exemption means a medical provider has determined the employee cannot safely receive the vaccine due to medical reasons. The religious exemption is more complicated, Parker said. Requests are reviewed by a committee following EEOC guidelines. If an employee does not agree with the committee’s decision, there are guidelines to protest the ruling.

Trustee Greg Bowman asked, “Can we staff the facility if we lose those folk?”

Parker said Share Convalescent is currently down to about 35 residents. With the decline in census and not admitting new resident “until we see what Dec. 5 looks like, I feel okay about it right now,” he said.

Share Medical Center CEO Kandice Allen said they need to figure out what happens to benefits when an employee is placed on furlough. Parker said he assumed the employee would have to be responsible for their own (insurance) premiums, but this was not addressed in the policy.

Later in the meeting, AHA attorney Rick Cunningham said employee benefits would be an administrative issue and did not need to be included in the vaccination policy.

Allen said a person placed on furlough would have those 60 days to come into compliance with the vaccination policy. Parker agreed, saying 60 days with no action would be accepted as their resignation.

“Technically, you could lose 20-some employees next week,” said AHA Chairman Jason Gaisford.

“I don’t think we will,” said Parker. He said two staff members already have medical exemptions. About eight or nine have submitted religious exemptions, which are in the review process. Several others have indicated they intend to get vaccinated before the Dec. 5 deadline.

“I still feel we’ll be able to take care of people without having to discharge anybody,” Parker assured the trustees.

Dr. Bo Hannaford said if Share Convalescent doesn’t comply, Medicare patients will be affected.

Parker said it’s not just Medicare but Medicaid as well. He said non-compliance would mean losing those depending on Medicare and Medicaid to pay their nursing home bills. “That would knock us down to 10 to 15 residents, and then we would have to lay off staff,” he said. They could continue operations for a while but would likely have to close their doors.

Dr. Kenneth Brown made a motion to approve the Mandatory Covid-19 Vaccination Policy for Share Convalescent Center. There was a pause. Gaisford asked if there was a second. Hannaford reluctantly seconded the motion saying, “They’re forcing our hand, and I don’t want to put any patients in jeopardy.”

With glum faces, trustees voted in favor as their names were called. Bowman cast the only dissenting vote.

Share Medical Center is currently developing their vaccination policy. A special meeting will be held Monday at noon to make that decision.

Alcohol Policy for Share Convalescent

The mood was much lighter as Parker presented the Alcohol Use by Facility Elders policy for discussion and approval. He said Share Convalescent had never had a policy for this although they have allowed residents to have alcohol in the facility with a doctor’s order.

However, a situation came up in October that showed them non-compliance by residents could cause harm to themselves or other residents. The alcohol policy will designate staff to purchase alcohol for activities such as happy hours and dinner parties at the facility. Residents and their families will obtain alcohol for personal use.

All alcohol is to be stored in the medication room and labeled. Alcohol is to remain in its original container. Doctor’s orders will be on file. Anyone bringing in alcohol for residents is to report it so staff may track it and make sure it complies with the doctor’s order.

The alcohol policy was approved unanimously.

CEO Report

Allen provided a written report and also reported orally during the meeting. She said the hospital had been busy on the floor. “We had some Covid back,” she said. They are still pushing for people to get vaccinated. Monday morning, the hospital had nine inpatients.

Mary Rose has stepped down as the director of surgery to semi-retire. As of Nov. 1, Amy Furrh is the new director of surgery and no longer working inpatient or ER. Furrh is currently assessing the needs of the department. Allen said Furrh had previous experience with a surgery department while working in Alaska.

The hospital is still looking into a couple of different options for surgery coverage. One is an orthopedic surgeon and the other is a general surgeon. Meanwhile, Dr. Gregg continues to stay busy with surgeries. He has agreed to be the hospital’s director of anesthesia.

The hospital has hired two new LPNs and two nurse aides. Three staff members have completed the TNCC (trauma) certification.

CFO Report

CFO Chris Lauderdale did not have financial reports. He said the hospital began using NextStep software for payroll in October, but they switched back to Paycom because it wasn’t working well. They are still waiting to get October reports from NextStep to be able to finish the financial reports.

Steve Knox, who has been handling the accounting for federal Covid grants, said the hospital had received considerable funding from Health and Human Services (HHS). Now it is time to report how those funds were used. Any funds received prior to July 1, 2020, must be accounted for with reports of how the funds were used from Jan. 1, 2020, to June 30, 2021.

Knox said the report was due in September but a two-month extension was granted because people were struggling with it. He said he had his report ready to file the next day.

There will be future reporting on following periods, “but this is the big one with the majority of the funds,” he said.

Chief of Staff Welcomed

Dr. Scott Burk, new chief of staff, was welcomed to the meeting. He gave a brief report on the medical staff executive committee meeting on Nov. 11. They recommended the appointment of Krystal Elliott, APRN to allied staff. She will be working mostly in Urgent Care. That appointment was approved by the trustees.

Share Convalescent Home

Parker reported the average daily census at Share Convalescent was just over 40 during October. He said 95 percent of the residents have been vaccinated. They had one unvaccinated resident, and another unvaccinated person moved in recently.

The nursing home is continuing to work with HPE, the engineering firm that is working on the new HVAC plan.

The doors ordered from Starr Lumber have finally arrived. “That was the longest order ever,” said Parker. The doors were ordered over a year ago, but supply problems delayed their arrival. They are now seeking a contractor to install the doors.

The nursing home will be implementing the nutrition management of PointClickShare, the electronic health records system they are installing.

The nursing home had five new employees in October and seven departures. Employee Baylee Miller was accepted into LPN school starting Nov. 1. Amy Kimberly completed her human resources certification. Harley Henning who had been a nurse aide has passed her LPN boards.

Parker said about 60 percent of the staff and contractors are vaccinated (43 total) with two partially vaccinated. There were 27 unvaccinated at the end of October although Parker said more had been vaccinated since then.

Multiple deaths and planned skilled nursing discharges brought the census down by the end of October. The nursing home received approximately $50,000 from Medicaid for supplement payment on Oct. 27 and a similar payment is expected in December.

The Homestead

Reporting on the Homestead retirement center, Parker said that facility does not have to comply with the vaccine mandate. The Homestead is currently averaging 30 residents.

The Homestead Café had to make adjustments to hours and to menus from Oct. 13 through Oct. 30 due to some employees having Covid. Parker said three of the 15 employees were affected, but that was enough to derail food service. During that time meals were prepared at Share Convalescent Home and catered to the Homestead.

Next Meeting

The AHA does not have a regular meeting scheduled during December. However, a Christmas party for staff and board members is scheduled for Dec. 13 at The Bull. CEO Allen promised brisket.

The next regular meeting will be Jan. 25, 2022.