Photos by Garrett Neese/Daily Mining Gazette Canal View - Houghton County Administrator Kim Salmi addresses the Houghton County Board Tuesday night.

HOUGHTON — Canal View – Houghton County Administrator Kim Salmi submitted her resignation Tuesday night, following the county board’s vote against a resolution asking for support of the facility by calling for relaxed masking and surveillance testing for nursing homes.

Salmi gave her 30-day notice after Tuesday’s board vote, which was 3-2 against the resolution.

“I consider many of my co-workers to be like family and I am passionate about the care that we provide for our elders,” Salmi said in the resignation letter to the county. “The ‘no’ vote at the Board of Commissioners meeting last night felt like a no confidence vote in my leadership capabilities. Since Houghton County owns the medical care facility, it is imperative that the leadership has the support of the commissioners.”

Wednesday, the county board scheduled a special meeting for 1 p.m. Friday to reconsider the motion.

Ed Jenich, chair of the Department of Health and Human Services board, which oversees Canal View, said there had been an informal meeting Friday with county board Chair Tikkanen and Vice Chair Roy Britz, the two members who had voted in favor of the motion. About 60 other people had also attended, Britz said.

The DHHS board has not accepted Salmi’s resignation. Jenich said Salmi had indicated she would hold off on a decision until after Friday’s vote.

“She tells me that if it doesn’t pass tomorrow, she’s done,” he said. “As a result of that, we’re losing good people. And how many people will go from there and decide that they’re no longer going to go back to work either? I have no idea whether or not we will fill her position right away. You need certifications, you need guidelines that you have to abide by. It’s a hard row.”

Salmi was added to Tuesday’s agenda after a Canal View Facebook page earlier this month in which she discussed the difficulties faced by nursing homes, employees and residents during the pandemic. Feedback from peers had been supportive, she said, with texts also coming in from hospital personnel.

Canal View and other nursing homes had seen staffing levels decrease as employees took short-term travel gigs. Morale had also been eroded by new restrictions regarding new bivalent vaccines that had restricted resident movement, she said.

“We do not work in a vacuum, and the things that affect the long-term care community have major effects on other parts of the community — hospitals, clinics, people’s ability to work because they don’t have anywhere from their mother or father or someone who needs care to go,” she said. “So they quit work, or they take a leave of absence, which is further affecting our workforce in the area. So this to me is more of a call of awareness and trying to get some momentum with us and other counties as well.”

Tuesday’s resolution called for the county to support Canal View by calling for relaxing continued masking and surveillance testing requirements for nursing homes, except in the case of suspected or confirmed COVID. The resolution also asked that the county recognize Canal View has followed applicable Michigan Department of Health and Human Services rules, Centers for Medicare & Medicaid Services (CMS) regulations and Centers for Disease Control and Prevention guidance, and that its practices and procedures have been effective at mitigating spread and severe illness. By adhering to core principles of infection control, the resolution states, Canal View has “thereby demonstrated their thorough knowledge and understanding of COVID-19 and should be able to continue to manage infectious diseases within their facility as such.”

As background, the motion cited the reduced spread and mortality rates after vaccines; only one resident had died from COVID after vaccines were introduced, Salmi said, and it was one who had chosen to stay unvaccinated. It also discussed the importance of nursing homes to the community, and outlined the reduced workforce seen since the start of the pandemic.

The number of health care workers moving to “gig models” had led to many health care workers leaving the area, the resolution stated. It cited a May 2022 survey from the consulting firm Oliver Wyman, which said the number of nurses moving to “gig models” such as traveling nurses or per-diem work had gone up 1,400% since the start of the pandemic.

Salmi said Tuesday she hoped the resolution would also spread a broader conversation about issues facing health care, such as issues in retaining contracted workers through agencies.

Of 10 people hired for a three-month contract, only about three complete it, she said; the rest leave midway for contractors paying more.

“We’ve become very quiet during the pandemic, because people have been very passionate about vaccines and nasty and everything one way or the other and what we’re not doing is talking about the issues that are really out there right now, which is staffing — staffing with people that live in our own community — which is fair wages, which is masking and following a lot of precautions that other places aren’t having to do,” Salmi said Tuesday.

Commissioner Glenn Anderson, who voted against the motion along with Commissioners Gretchen Janssen and Kevin Codere, called the resolution “misplaced and misguided” at Tuesday’s meeting. The staffing issues brought up in the motion may be connected to COVID regulations, but that’s not the only potential reason for them, he said.

In some cases, certified nursing assistants working as general contract employees are making more than licensed practical nurses or registered nurses, Anderson said. Many nursing homes are also requiring 16-hour shifts, he said.

“That’s partially a staffing shortage, partially it’s COVID,” he said. “That could be a lot of things.”

Anderson also said he didn’t think the county board should involve itself in what the federal regulations for health precautions should be.

“It’s a federal issue,” he said. “I think it’s above our pay grade.”

Tikkanen said the county should weigh in.

“I think that the government works for the people,” he said. “And it’s from the local level that that directive should be flowing, not the other way around.”

A message was left Wednesday seeking comment from CMS, which sets federal regulations. Thursday afternoon, a CMS spokesman said the agency was preparing a response for sometime Friday.

Jenich said staffing levels at Canal View were down considerably from before the pandemic. Because of regulations governing how many staff members are needed per resident, the facility is well below capacity; 127 residents in the 190-capacity building, with a waitlist of more than 80 people.

Jenich said he wasn’t sure if loosening the federal regulations would improve the employment situation, but at the least, it wouldn’t hurt, he said.

“I do believe that people should wear a mask when they’re going into a health-care institution,” he said. “I believe that they have to check as to what’s what, but I don’t think we have to go through the tight routine that we did two years ago, and we’re still maintaining that we have to do this. As a result, we’re scaring people away. We’re scaring employees that want to work away.”

Thirty Canal View administrators and employees sent a letter to the Houghton County Board after the vote urging it to reconsider. They called Salmi an “exemplary leader” who Canal View needs to keep to continue its quality of care.

“The lack of support given at the meeting shows not just lack of support for Kim Salmi, but for the entire staff of Canal View,” the letter said. “With all due respect, all that was being asked for, was your support to lessen current regulations within our facility. Canal View – Houghton County will obviously continue to follow CMS and State of Michigan rules and regulations, while continuing the care of our residents in a safe environment.”