On Wednesday, President Joe Biden unveiled a new plan requiring nursing homes to vaccinate their employees or lose federal funding. Industry members are concerned the mandate will exacerbate current staffing shortages and make it harder for facilities to care for their residents.
Biden ties employee vaccination to federal funding for nursing homes
Biden announced on Wednesday that nursing homes will have to require their workers be vaccinated against Covid-19 to receive Medicare and Medicaid funding, the New York Times reports.
CMS is expected to release an emergency rule covering this new requirement in September, according to Roll Call. Officials said the decision will affect more than 15,000 nursing homes with around 1.3 million workers across the country.
In a statement, CMS administrator Chiquita Brooks-LaSure said, "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."
As of Aug. 8, federal data showed that around 62% of all nursing home staff are currently vaccinated. But vaccination rates vary widely by state, with a high of 88% in some states and a low of 44% in others.
In addition, according to data from CMS, nationwide Covid-19 cases in nursing homes have increased from 319 cases on June 27 to 2,696 cases on Aug. 8. Since the beginning of the pandemic, federal data shows that around 134,000 nursing home residents and nearly 2,000 employees have died from Covid-19.
How will the vaccine mandate affect nursing homes?
According to Roll Call, divisions among nursing home staff about a vaccine mandate has some people in the industry—which has long suffered staffing shortages—concerned that even more workers will leave.
Lori Porter, CEO of the National Association of Health Care Assistants, said she is worried the industry could lose 20% to 30% of its workforce over the new vaccine requirement.
And Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living, said a broader vaccine mandate for all health care organizations, instead of just nursing homes, is necessary to prevent further staffing shortages.
"Focusing only on nursing homes will cause vaccine hesitant workers to flee to other health care providers and leave many centers without adequate staff to care for residents," Parkinson said. "It will make an already difficult workforce shortage even worse."
Similarly, Katie Smith Sloan, president and CEO of LeadingAge, a nonprofit that represents more than 5,000 aging services providers, said the vaccine mandate should be extended to all health care workers in all settings. She also voiced concern that cutting funding to nursing homes will further hurt facilities that have struggled financially throughout the pandemic.
"Without Medicaid and Medicare funding, nursing homes cannot provide the quality care that our nation's most vulnerable older adults need," Smith Sloan said. "Our mission-driven nursing home members, who operate on narrow margins in the best of times, depend on those funds alone to care for their residents."
Separately, David Grabowski, a professor of health care policy at Harvard Medical School, said funding cuts could put some nursing homes "in a precarious position" and that he believes there will be a "tremendous amount of pushback in the industry."
Grabowski noted that while a national vaccine mandate could "level the playing field" for nursing homes looking for employees, they may still struggle to retain employees with jobs in other areas, such as retail or hotels, offering similar pay. "I think this is a good measure, but it needs to be paired with additional resources to help pay staff and make sure these are jobs they want to stay in," he said. (Clason, Roll Call, 8/18; LaFraniere et al., New York Times, 8/18; Christ, Modern Healthcare, 8/18)
