ATLANTA — Even with a massive undertaking led by the Georgia National Guard to disinfect nursing homes across the state, one-third of COVID-19 deaths in Georgia have been at long-term care facilities.

The insidious spread of coronavirus within nursing homes has infected 17,166 residents and killed nearly 3,000. With strict sanitation guidelines and the stress of shutting doors to family and visitors, staff have been pushed to the brink, administrators said.

As of Nov. 25, 661 facilities have reported COVID-19 cases within their walls.

During a roundtable Monday, Gov. Brian Kemp assured nursing home administrators the state is prepared to rollout an approved coronavirus vaccine as early as the second or third week of December.

“I”m confident that when the vaccine is authorized — which I believe will be sooner rather than later — we will be ready to distribute that.” he said.

But with vaccines still on the horizon, administrators who testified relayed stories of critical staffing levels and empty beds that have caused millions in lost revenue a day.

“We lost a lot of staff to begin with because they were afraid,” Mark Todd, president and CEO of Magnolia Manor, a faith-based senior living organization with facilities in rural Georgia, said. “We had a lot of long-term employees specifically that said ‘we’re not going to deal with this anymore.’ So, we’ve been in a critical staffing situation, almost from day one.”

The living facilities part of the nonprofit organization are down anywhere between 20 to 25% resident population, Todd said — which as of now — is “a blessing” with the decrease in employees. But once a vaccine is distributed, their current staffing levels would not be able to handle a normal level of residents.

“Where that puts us moving forward is in a really difficult situation because if the vaccine comes in… if the medical community gets back to normal and we start seeing the same numbers of people that need the services that we have and all of a sudden our census takes off and grows,” he said. “We’re not going to be able to manage that. We don’t have the people in place — now or in the future — to do that.”

Other nursing home administrators echoed similar concerns of burnt out staff and falling revenue.

Ron Westbury operates four nursing home facilities in middle Georgia that are barely “muddling through,” he said. The Jackson facility, Westbury Medical Care and Rehab, has been overrun with the virus — 159 residents have tested positive and 35 have died, he said. One employee also died after contracting COVID-19.

“We’ve got 50 employees that have been with us for 25 years. And what we’re finding is for those folks this has been a hellish year and they’re just saying ‘I’m done.’” Westbury said. “… It’s hard to get new people in because of the wages that we are able to pay.”

Tony Marshall, president and CEO of the Georgia Health Care Association which represents long-term care providers said that while revenue is dipping because of falling resident  population, costs are increasing.

At this time last year, there were around 34,500 patients residents across the association’s member nursing centers on any given day, he said. As of Nov. 25, that number was down to 28,100 — the 6,000 resident decline equivalent to about $1.2 million in lost revenue per day.

“That’s what creates a lot of the challenge that you see within our setting: the combination of lost revenue with increasing expenses,” Marshall said.

Marshall did note that under Kemp’s executive action and a waiver submitted by the Centers for Medicare and Medicaid Services, the state has been able to train over 3,500 temporary nurse aides to help offset staffing losses.

“Without those individuals being able to come in place, our workforce challenges would have been beyond difficult and would have almost been impossible,” he said.