RALEIGH, N.C. (WNCN) — Up to 90 percent of nursing home residents who have been offered coronavirus vaccines so far have taken it, even as roughly half of employees have declined it, the CEO of the trade group that represents those homes in North Carolina told CBS 17 News on Wednesday.

Adam Sholar, the president and CEO of the North Carolina Health Care Facilities Association, called it “concerning, to be sure” and said his group has heard anecdotes similar to one shared by state Department of Health and Human Services Secretary Dr. Mandy Cohen, who said earlier this week that most nursing home workers are refusing vaccines.

He said he would “encourage everybody to take it as soon as you can — that’s unequivocal,” and added that he thinks those workers are taking a “wait-and-see” approach during the first of three on-site clinics spaced 28 days apart as part of the federal partnership program.

“The predominant response from those not taking the vaccine during Clinic 1 is, ‘I’m not convinced, I want to watch my colleagues who have decided to take it and our residents who are taking it, and if they have a good experience with the vaccine, then I’ll probably take it at the next clinic,’” Sholar said.

“I’m also optimistic that there are going to be more people that decide to take the vaccine at that second clinic,” he added. “And so long as we’re going to see really high resident acceptance percentages, those who are at risk for the most severe disease impact, this prioritization for these vaccines I think will really have a positive impact.”

It comes as a growing number of nursing homes across the state report some kind of staff shortage as the COVID-19 pandemic has worsened, according to a CBS17.com analysis of federal data.

A total of 116 of the 405 nursing homes in North Carolina that responded to a federal survey — or, more than 28 percent — said they were short on either nurses, aides, critical staff or other staff members.

That percentage has climbed gradually but steadily since the summer, with 27.9 percent of homes reporting such a shortage in October and 27.8 percent doing so in June.

“I don’t know another way to say it other than it’s as bad as it’s been,” Sholar said.

Dr. Donald Taylor of Duke University’s Sanford School of Public Policy said the problem of finding enough employees at nursing homes predates the pandemic.

“Like so many other things, COVID has made it worse,” he said, “but it hasn’t created the problem.

“Nursing homes have long struggled to have enough staff, and that’s basically because it’s a hard job and it doesn’t pay that well,” he added. “That’s really the short answer.”

It comes despite a steady decline in the occupancy rates of those homes, with the most recent figures from late December showing 70 percent of total beds — down from 72 percent in October and nearly 76 percent in May, when the Centers for Medicare and Medicaid Services began releasing that data.

There are several reasons for it, some of them anecdotal — from people postponing elective surgeries that would have led to stays in nursing homes to patients being treated at home by family members instead of those facilities because of the risk of COVID, which has been rampant in nursing homes. 

More than 300 facilities across North Carolina are currently experiencing outbreaks, according to the most recent biweekly update from DHHS. More than a third of the state’s 7,076 deaths have involved nursing homes.

That could lead to a vicious cycle: Fewer residents in nursing homes means less money for those homes, which makes it hard to pay workers.

“It’s a pretty low margin business, which I think in the end is why employees are paid relatively low wages given how important their services are to people who need them,” Taylor said. “When you have occupancy rates lower, in one sense that might be better for quality in that when you have high occupancy, you might have fewer providers or fewer care workers than you would wish per residents. But … it’s a business, and it makes it difficult to invest more in workers.”

CBS 17’s Joedy McCreary has been tracking COVID-19 figures since March 2020, compiling data from federal, state, and local sources to deliver a clear snapshot of what the coronavirus situation looks like now and what it could look like in the future.