Saving Money and Saving Lives in Nursing Homes

Currently flu shots can't be mandated for nursing home employees, but they can be strongly encouraged. The following actions would be both cost-effective and relatively easy to implement.

 Free flu shots for nursing home employees. Insurance companies and nursing homes would spend a lot less paying the $10 cost of a flu shot for each employee than they would pay to stop the resulting outbreak and treat nursing homes patients who contract the flu.

 Payments to nursing home employees who get flu shots. One nursing home recently offered $150 to each employee who received a flu shot and achieved very high rates of immunization very quickly. This is a lot cheaper than treating residents who contract the flu.

 Vaccinate employees first, before nursing home residents get the flu shot. Employees are harder to get to when it comes to arranging the flu shot, so the effort to immunize always takes longer for them than for residents. Employees also keep their immunity much better and longer than residents, so immunizing employees early is acceptable if supplies arrive on time.

 Employee education. Many nursing home employees are afraid that the immunization will give them the flu or cause other health problems. A well-directed education campaign can alleviate these fears and help employees understand the benefits of immunization.

 Requiring that the level of employee immunization for each nursing home be publicly reported, so that prospective nursing home residents and their families could use this knowledge in selecting a safe nursing home to live. Currently, only the level of immunization for residents is publicly reported. In an effort to attract more residents, nursing home owners might seek to boost employee immunizations if that statistic was also reported.

For many young and middle-age Americans, the flu is an unpleasant inconvenience. A stuffy nose, fever, headache, stiffness, perhaps a few days missed from work or school. But for many vulnerable older Americans in nursing homes, the flu is a killer. Too many are dying needlessly.

Programs to create incentives for more nursing home employees to get flu shots can save thousands of lives and save money at the same time. The families of nursing home residents, nursing home owners, employee representatives, insurance companies and government officials should unite to create such incentives in time for the next flu season.

Lisa Shugarman is a health policy researcher at the RAND Corporation, a nonprofit research organization.