Many long-term care staff and residents in Arizona are skipping the COVID-19 bivalent booster shot. David Voepel is the CEO of the Arizona Healthcare Association, which represents nursing homes in the state. 

"Arizona's last in vaccine uptake, and not just the regular vaccine, but I'm talking [about] the bivalent booster. And we're lasted that both on staff and on residents," Voepel said. 

Voepel met with Health Human Services Secretary Xavier Becerra, who was in Phoenix earlier this month. Voepel told Becerra that a widespread education campaign is needed to help staff and residents understand the benefits of the updated booster. 

Boosters are one hurdle. Skilled nursing facilities are facing personnel shortages. It's a dangerous prospect, especially for older adults who may need that additional support following a hospital stay.

"Because we can't get staffing, we can only take so many people, we can only do so many admits," Voepel said. 

So, where do these individuals go if they can’t go to a skilled nursing facility? Voepel says they’re either staying in the hospital or going home.

"And sometimes that can be a double edged sword, because then they might not get the care they need at home. And they might have to go to the back of the hospital and be a re-admission, which hurts the hospital too financially," Voepel said.