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With its first COVID-19 vaccination booster clinic on the calendar for next week, one Washington, D.C.-based long-term care provider said its staff and residents are lining up after seeing the results of initial vaccinations on community life.

“It’s not going to be as much of an uphill battle. It’s not mandatory, so we’re not pushing people against a wall,” Forest Hills CEO Tina Sandri said Monday during a LeadingAge membership call. “They’ve already seen the good, so the emotional resistance is not there as much. Most are just asking, ‘When’s the booster coming?’”

With COVID-19 vaccination booster shots open to all U.S. adults officially as of Friday, Sandri said that 98% of staff members at the community — which offers assisted living, memory care, skilled nursing and rehabilitation — already have rolled up their sleeves and have seen that “everyone’s been OK.” There have been no resident coronavirus cases since January, she said, and the three to four employee cases have not led to community spread.

Sandri said the community lost a security guard, a registered nurse and a certified nurse assistant over the District of Columbia’s vaccination mandate for healthcare employees. But with only two employees requesting religious exemptions, excitement is building over the upcoming booster clinic, she added. 

Visitation guidance

Sandri also addressed the updated nursing home visitation guidance that came out Nov. 12 from the Centers for Medicare & Medicaid Services, which permits visitation for all residents at all times. 

Although CMS doesn’t oversee assisted living and memory care providers, Sandri said that Forest Hills applied the CMS guidelines to the entire campus. In fact, she said, the District of Columbia treats assisted living similar, in terms of guidance, to skilled nursing facilities.

And although the doors might be open, Sandi said that many COVID-era practices, including core principles of infection control, must continue to be observed.

With the CMS guidance in mind, Forest Hills implemented a voluntary online signup program that provides another way of communicating with families that want to visit loved ones on the campus. Visitors can sign up for a time to visit their loved one to avoid any delays as the community continues to limit visitor numbers to allow for social distancing and proper infection control.

The program also asks a visitor’s vaccination status and reinforces the community’s request that visitors go straight to a loved one’s room or designated space for a visit to minimize any contact spread.

“It might look a little different than it did before, in terms of social distancing and space,” Sandri said. “We still have to layer COVID safety protocols.”

Workforce challenges

When it comes to workforce challenges, Sandri said, society is getting to more of an “endemic” stage. After witnessing some “megatrends” outside of healthcare, including “the great resignation of the workforce,” Sandri said, Forest Hills has made some adjustments to maintain services. 

“It’s really hard to be attractive right now,” she said, adding that she has streamlined processes and workflow and automated what she can when she can’t fill a vacancy. 

“If we get notice that someone is quitting without a lot of notice, our buildings can still function, and we’re not held hostage to a vacancy,” Sandri said. “The biggest lesson is, we have to learn how to be more efficient with the work teams we have.”

One way the community is engaging its certified nursing assistants is through an apprenticeship program, to develop career ladders in the end-of-life, Alzheimer’s and restorative care areas. Working through a grant, Forest Hills partnered with a CNA school to create a pilot apprenticeship program. CNA mentors get a small bump in salary, and the program creates a workforce pipeline.

Sandri said that Forest Hills plans to open its CNA apprentice program to train workers from other communities and will offer its expertise to those communities looking to establish their own apprentice programs.