There was a time earlier in the pandemic when Lincoln Court Retirement Community in Idaho Falls, and Countryside Care and Rehab in Rupert, tried to keep their residents safe. But the coronavirus still made its way inside.

That’s what happened in more than 75% of the long-term care facilities in Idaho. Outbreaks led to more than 800 deaths and almost 10,000 cases of COVID-19 in Idaho nursing homes, assisted living facilities and group homes for people with disabilities.

Then, in the middle of winter, vaccines arrived.

Long-term care residents and staff were among the first Idahoans eligible for the shots.

But even after witnessing months of death and illness, some employees declined the vaccine.

Lincoln Court has since made its vaccination rates a success story – with every resident and almost every employee choosing to get vaccinated when the shots first became available. And Countryside Care and Rehab has offered a real-world example of how well the COVID-19 immunizations work.

“The vaccine to me is a miracle. It’s a miracle,” said Tom Murphy, CEO of Minidoka Memorial Hospital, which operates the Countryside skilled nursing facility.

The care center has lost seven residents to COVID-19. Since vaccinations began protecting its residents, though, nobody at Countryside has died of the disease, Murphy said in an Aug. 13 interview.

President Joe Biden this week announced a new requirement that staff in nursing homes must be vaccinated for COVID-19, or the facilities risk losing Medicare and Medicaid payments, which make up the majority of revenues for nursing homes in Idaho and elsewhere.

The COVID-19 vaccination rates in Idaho nursing homes range from 52% to 100% for residents, and 26% to 99% for health care staff, according to federal data for the week ending Aug. 8.

Statewide, the average COVID-19 vaccination rate is 86% for nursing home residents and 59% of health care staff, with a small share of those having just their first dose of the vaccine so far.

The nursing home with the highest staff vaccination rate in Idaho right now is Canyon West of Cascadia in Caldwell. It was hard hit by COVID-19 before vaccines became available, with more than 120 cases and 11 deaths, according to state data.

The requirement won’t apply to residential assisted living facilities like Lincoln Court, which are state regulated. There currently is no state requirement for vaccination in long-term care or any other industry.

Vaccine hesitancy remains a challenge in Idaho care facilities

Murphy said in a recent interview that, across the whole Minidoka organization, about 60% of employees are vaccinated.

About 93% of residents and 52% of health care staff in the Countryside nursing home were fully vaccinated as of Aug. 8, according to federal data.

The nursing home will be one of dozens in Idaho that will have to comply with Biden’s new mandate.

“We are strongly encouraging the vaccine, and we’re doing lots of education,” he said. Asked if he plans to require staff to be vaccinated, he said he doesn’t even want to utter the word “requirement” at this point.

The vaccines have made this year different from the last, though. He said fewer staff are out sick with COVID-19. Fully vaccinated patients come to the hospital sometimes, with breakthrough cases, but they don’t need to be admitted for severe illness.

“Virtually all of our admissions are unvaccinated,” he said.

A retirement community’s message: Think about others who are vulnerable

Lincoln Court managed to stave off COVID-19 almost all of last year. But in October 2020, it arrived.

“When we had our first case … it hit us really hard,” Matthew Johnson, executive director of Lincoln Court. “We had over 100 positive cases between residents and staff” within a six-week period.

“We personally have seen people pass away because they got this virus,” he said.

State records show there were eight deaths at Lincoln Court related to COVID-19.

Johnson says he knows vaccines are “a really sensitive topic” even when there’s not a politicized pandemic in the mix.

“When you add that to the emotions of what 2020 felt like to everyone, and then you amplify that by putting us in a place where we’re working with a vulnerable population who really is affected in a major way by the virus,” it takes on a lot more weight, he told the Sun.

Johnson said his team broached the topic of vaccination with staff before the shots even arrived.

Director of Nursing Olivia Beckman met one-on-one with every resident. Johnson focused his attention on the people who worked at Lincoln Court.

“When I had staff say, ‘Matt, I’m nervous about getting the vaccine. I feel like there’s not enough research,’ I said, ‘So am I. But … if there’s a chance that my being vaccinated prevents one of our residents from getting COVID, that’s worth it to me.”

They answered questions about the vaccines, which have been in clinical trials for more than a year, rely on technology that was in use long before the pandemic, and have now been given to more than half the U.S. They tried their best to dispel fears. But above all, Johnson said, they asked their staff to think about how it would help their residents.

A sales pitch for COVID-19 vaccines: Return to normalcy

Johnson asked people to set aside their political beliefs or personal concerns, reminding them that they chose to work in a field where their choices directly affect their residents’ lives.

“We had to lock our communities down and not allow our (residents’) families to come into the building, and limit residents being able to leave only for essential appointments,” Johnson said.

He and his leadership team talked about what life at Lincoln Court could look like.

With a thick layer of protection from COVID-19 vaccines, they could invite families back in for visits. They could revive small group activities. Residents could return to the dining room. The vaccines would give Lincoln Court’s residents some freedom again.

After the first two vaccine clinics, employees who had been too nervous eventually saw “that none of us grew a tail, none of us died from getting the vaccine,” he said.

The facility set up one extra clinic with Walgreens, to make sure all their workers got their vaccines.

But they also seized the opportunity “to vaccinate just a ton of family members,” Johnson said. “We helped vaccinate right in the neighborhood of like 250 to 300 people.”

They invited home health and hospice workers, doctor’s offices they worked with, and others who came into contact with their residents.

“We feel like the more people that could be vaccinated, the safer our residents would be,” Johnson said.

Lincoln Court’s high vaccination rates caught the attention of local media – and state long-term care officials, one of whom emailed to congratulate Johnson and ask, “What is your secret?”

Keeping up vaccination rates by asking people to commit

Now, the company policy is, “If you want to work for us, or if you’re a resident who moves in, it’s not a choice. You have to sign a document” committing to vaccination within 90 days, he said. “I’ve been surprised that people are fine with it.”

The vaccination rate now hovers in the 80% range for staff and nearly 100% among residents, he said.

One staff member who chose not to be vaccinated has tested positive, and the building had to close for seven days, Johnson said. “That solidified our stance on why it’s important for as many people as possible to be vaccinated,” he said.

The facility has otherwise stayed COVID-free through mid-August. Nobody else caught the virus from the unvaccinated staffer, even though that employee had contact with others, he said.