Nursing Home Staff Must Get Vaccinated or Risk Medicare Funding

Nursing home staff must get vaccinated against COVID-19 or risk losing Medicare and Medicaid funding, President Biden announced Wednesday. The announcement comes at a time when healthcare worker vaccine uptake is slowing down, particularly in long-term care settings.

The emergency regulation, to be developed in collaboration with CMS and the Centers for Disease Control and Prevention (CDC), aims to ensure the safety of nursing home staff and residents who are particularly vulnerable to COVID-19.

“More than 130,000 residents in nursing homes have sadly, over the period of this virus, passed away. At the same time, vaccination rates among nursing home staff significantly trail the rest of the country.  The studies show that highly vaccinated nursing home staffs is associated with at least 30 percent less COVID-19 cases among long-term care residents,” President Biden asserted.

“With this announcement, I’m using the power of the federal government, as a payer of healthcare costs, to ensure we reduce those risks to our most vulnerable seniors.”

The regulations will apply to more than 15,000 nursing homes, which employ around 1.3 million workers, the Washington Post reported.

But even before the announcement was made, healthcare systems were concerned about the potential strain that nursing home staff vaccine mandates would have on already existing staffing shortages.

As of August, 60 percent of facilities wanted to require staff to be vaccinated, according to a survey conducted by the Maine Medical Directors Association reported from a local news outlet. But resources are already stretched thin, and many respondents worried that a vaccine mandate would only exacerbate staffing shortages.

The virus’ risks to patient safety are especially prevalent in nursing homes, putting the facilities in a difficult situation: either mandate vaccines and potentially lose employees, or don’t and risk losing more patients to COVID-19.  

Over 130,000 nursing home residents and 2,000 employees died due to COVID-19, according to the most recent CDC data. However, vaccination rates among nursing home workers remain low. About 60 percent of staff per facility are vaccinated, compared to 82.8 percent of residents per facility.  

“Keeping nursing home residents and staff safe is our priority. The data are clear that higher levels of staff vaccination are linked to fewer outbreaks among residents, many of whom are at an increased risk of infection, hospitalization, or death,” Chiquita Brooks-LaSure, the CMS administrator, stated in a press release.

“We will continue to work closely with our partners at the CDC, long-term care associations, unions, and other stakeholders to advance policies that keep residents and staff safe. As we advance these new requirements, we’ll work with nursing homes to address staff and resident concerns with compassion and by following the science.”

AMA recently expressed its support for vaccine mandates for healthcare workers as the highly contagious Delta variant takes more lives daily.

Healthcare employers that implemented employee vaccine mandates recently faced backlash in some areas. Over 150 employees at Houston Methodist resigned or were fired after the health system mandated vaccinations.

Encouraging hesitant healthcare workers to get the vaccine may require some behavioral science tactics. A recent research letter found that individually addressed email reminders driven by behavioral science were effective at reducing vaccine hesitancy among healthcare workers.

Meanwhile, researchers across the country are studying other ways to get through to hesitant workers at skilled nursing facilities and other long-term care settings. The Patient-Centered Outcomes Research Institute (PCORI) just approved $11 million to fund two studies aimed at combatting the issue.

CMS expects to issue its emergency regulation in September, requiring nursing homes to comply despite staffing shortage concerns. Otherwise, these facilities risk crucial federal funding.

“CMS also expects nursing home operators to use all available resources to support employees in getting vaccinated, including employee education and vaccination clinics, as they work to meet this staff vaccination requirement,” the agency stated.