Nursing home groups decry mandate push by CMS for staff to get COVID-19 vaccine

Several nursing home advocacy groups charge that the Biden administration is unfairly penalizing the industry with a staff vaccination mandate, even as data show rates have languished among staff.

The Centers for Medicare & Medicaid Services (CMS) announced its intention to issue an interim final rule by next month stating that if staff do not get the COVID-19 vaccine, facilities could risk losing funding. Several nursing home associations blasted the requirement as heavy-handed and inappropriate in light of a lingering staff shortage exacerbated by the pandemic.

Penalizing nursing homes by “withholding or withdrawing funds is not the right way to increase vaccination rates,” said Katie Smith Sloan, president and CEO of LeadingAge, an association of nonprofit aging service providers such as nursing homes, in a statement after the CMS announcement. “Without Medicaid and Medicare funding, nursing homes cannot provide the quality care that our nation’s most vulnerable older adults need.”

Sloan said the group has encouraged its members to require vaccinations for staff as a condition of employment, with exceptions for religious or medical reasons.

Other groups have argued that a federal mandate could hamper efforts to get enough staff to care for patients.

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The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) said Wednesday that the government needs to add more provider groups for vaccine mandates.

“Focusing only on nursing homes will cause vaccine-hesitant workers to flee to other healthcare providers and leave many centers without adequate staff to care for residents,” said AHCA/NCAL President and CEO Mark Parkinson in a statement.

Nursing home employment has been hit hard since the onset of the pandemic and has remained stubbornly low even as other sectors of the healthcare industry have rebounded.

The nursing home industry has seen an 11.5% decline in its workforce since February 2020, a decline of 182,000 jobs, according to a report released in March by consulting firm Altarum.

The decline was less pronounced in other parts of the healthcare industry. For example, Altarum found hospital employment had declined by 2% from February 2020.

A vaccine mandate focused just on nursing home staff could create a “disastrous workforce challenge,” said Parkinson.

Vaccination rates, however, appear to have lagged among staff, according to data from the AARP.

An analysis released last month from the group found that 4 in 5 nursing homes were behind on their goals for staff vaccinations.

The latest data from the CMS as of Aug. 8 show that 60% of staff were vaccinated nationally compared to 82% of nursing home residents who were fully vaccinated.

It remains unclear whether the hospital industry could face a similar vaccine mandate from CMS or risk losing Medicare funding.

However, more than 130 hospital systems have implemented their own mandates.