Biden administration to require vaccination of all nursing home staff

President Biden on Wednesday said his administration will require nursing home staff across the country to be vaccinated against COVID-19, and will withhold Medicare and Medicaid funding from those facilities that don’t comply.

The new regulations would apply to over 15,000 nursing home facilities, which employ approximately 1.3 million workers and serve approximately 1.6 million nursing home residents.

“More than 130,000 residents of nursing homes have sadly, 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,” Biden said in remarks at the White House. “With this announcement, I’m using the power of the federal government as a payer of health care costs to make sure we reduce those risks to our most vulnerable seniors. These steps are all about keeping people safe and out of harm’s way.”

Vaccination rates among nursing home staff are lagging, threatening the progress the nation has made in protecting the vulnerable elderly. 

More than seven months after becoming eligible, only about 60 percent of staff in nursing homes and long-term care facilities nationwide are partially or fully vaccinated, according to federal data compiled by CMS.

Only about one-quarter of nursing homes had at least 75 percent of staff vaccinated, which is the benchmark goal the industry has set for vaccinations in facilities.

Nursing homes have been devastated by COVID-19. Residents make up only about 1 percent of the U.S. population, but account for more than 20 percent of all deaths nationwide.

According to Medicare data, the disease has killed more than 133,000 residents and nearly 2,000 staff members. That’s also likely an undercounted figure, since facilities only began reporting at the end of May 2020.

The authorized vaccines have been shown to greatly reduce serious illness and death in elderly people, but the delta variant is fueling new concerns, and infections are rising among residents.

According to CMS, cases spiked from a low of 319 on June 27, to nearly 2,700 cases on August 8, with many of the recent outbreaks occurring in facilities located in areas of the United States with the lowest staff vaccination rates.

A study released by the Centers for Disease Control and Prevention on Wednesday showed vaccine effectiveness is waning in nursing home residents as the variant spreads. 

The announcement is part of the administration’s increasingly firm approach to increasing vaccination rates in the country.

The Department of Veterans Affairs late last month was the first federal agency to require certain employees to get vaccinated against COVID-19, and the Department of Defense this week said it will require members of the military to be vaccinated.

President Biden is also requiring all federal workers and contractors to sign forms attesting they’ve been vaccinated, or be subject to mandatory masking, distancing and testing rules.

But one of the nation’s largest long-term care industry groups said Biden needs to make vaccination a requirement for all health workers, not just for nursing home staff. Otherwise, it could result in large-scale staff exodus.

“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,” said Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living.

“The government should not single out one provider group for mandatory vaccinations. Vaccination mandates for health care personnel should be applied to all health care settings. Without this, nursing homes face a disastrous workforce challenge.” 

Updated at 6:10 p.m.