Staff members sitting in chairs and laughing

After a resurgence of COVID-19 cases among staff and residents in its senior living and care communities over the summer, and rumblings about another variant on the horizon, Evangelical Lutheran Good Samaritan Society knew it was time to act.

COVID-19 vaccination rates at the time were lagging, recalled President and CEO Nate Schema, speaking during a Wednesday LeadingAge membership meeting. 

As the nation’s second-largest not-for-profit multi-site senior living organization, according to the LeadingAge Ziegler 200 list for 2021, it was seeing 1,000 positive COVID-19 cases on a daily basis among its more than 12,000 staff members, and just as many on the resident side.

Schema said it was July 16 when the Sioux Falls, SD-based provider said that enough was enough and decided it wasn’t going back to the early days of the pandemic.

“We drew a hard line in the sand. We want to be one of the safest places to work and live,” Schema said. That was when the company, with facilities in 22 states, decided it was not turning back but moving forward with a staff vaccination mandate.

Conditions were announced in July, giving staff members until Nov. 1 to be fully vaccinated. Good Sam had some early eager adopters, including a handful of communities that reached a 90-plus percent vaccination rate within weeks.

The provider’s leaders used town halls, visits from senior leaders, websites and one-on-one conversations to work through barriers to vaccination for some staff members.

“Having a tool like the vaccine was our way out, our way forward,” Schema said, adding that he saw a 96% reduction in coronavirus cases in its buildings after announcing the mandate. “It has been an absolute game-changer.”

The mandate also became a marketing tool, especially for its assisted living and other senior living communities, where prospective residents initially were reluctant to move to any institution that might impose visitation restrictions. With a current staff member vaccination rate of more than 95%, he said, families welcomed the staff mandate more than anything over the past couple of months.

Schema said that the company approved exemptions — mostly religious ones — to approximately 10% of its staff. To accommodate those employees, he said, buildings heightened infection control protocols and carefully screened employees before each shift. 

Good Sam furloughed approximately 2% of its employees — mostly seasonal and as-needed (PRN) workers — who refused vaccination, although he said that many workers returned to communities after government vaccination mandates were announced.

He said that Good Sam is “all in” when it comes to vaccination, indicating that the company is committed to an annual vaccine process.

Workforce challenges

With workforce challenges existing before the pandemic, Schema said that he considers vaccine mandates and workforce shortages two separate issues. 

Wage wars, he said, are a bigger problem, and he called bonuses and incentives a mixed bag. Workers, particularly in the upper Midwest, are playing the system by taking a sign-on bonus at one community and then jumping to another location for another bonus, Schema said. 

To combat that practice, he added, Good Sam is looking at retention bonuses and is getting creative in building additional dollars into wages over time if workers stay. 

“We have to do things differently as an industry,” Schema said. “We have to continue to really adapt if we’re going to be able to compete for folks with jobs open right now.”