WASHINGTON — President Joe Biden on Wednesday announced that his administration will require that nursing home staff be vaccinated against COVID-19 as a condition for those facilities to continue receiving federal Medicare and Medicaid funding.
Biden unveiled the new policy Wednesday afternoon in a White House address as the administration continues to look for ways to use mandates to encourage vaccine holdouts to get shots.
“If you visit, live or work in a nursing home, you should not be at a high risk for contracting COVID from unvaccinated employees,” Biden said.
The new mandate, in the form of a forthcoming regulation to be issued by the Centers for Medicare & Medicaid Services, could take effect as soon as next month.
Hundreds of thousands of nursing home workers are not vaccinated, according to federal data, despite those facilities bearing the brunt of the early COVID-19 outbreak and their workers being among the first in the country to be eligible for shots.
It comes as the Biden administration seeks to raise the costs for those who have yet to get vaccinated, after months of incentives and giveaways proved to be insufficient to drive tens of millions of Americans to roll up their sleeves.
In just the past three weeks, Biden has forced millions of federal workers to attest to their vaccination status or face onerous new requirements, with even stricter requirements for federal workers in frontline health roles, and his administration has moved toward mandating vaccines for the military as soon as next month.
Biden has also celebrated businesses that have mandated vaccines for their own workforces and encouraged others to follow, and highlighted local vaccine mandates as a condition for daily activities, like indoor dining.
The new effort seems to be paying off, as the nation's rate of new vaccinations has nearly doubled over the past month. More than 200 million Americans have now received at least one dose of the vaccines, according to the White House, but about 80 million Americans are eligible but haven't yet been vaccinated.
Mark Parkinson, the president and CEO of the American Health Care Association and National Center for Assisted Living, praised the Biden decision, but called on him to go further.
“Vaccination mandates for health care personnel should be applied to all health care settings,” he said. “Without this, nursing homes face a disastrous workforce challenge.”
Last year CMS used similar regulatory authority to prohibit most visitors from nursing homes in an effort to protect residents.
Marjorie Moore with Voyce, a Creve Coeur-based nonprofit that advocates for families of nursing residents, said the mandate will save the lives of countless nursing home residents and ensure visits from loved ones.
“Every time a staff member or resident tests positive with COVID-19, a facility has to shut down for a few days to a few weeks,” Moore said. “That increases the social isolation of residents and decreases their mental health. A fully vaccinated long-term care workforce is the smartest and safest way to take care of our loved ones in long-term care.”
Missouri has the third worst vaccination rate among nursing home staff in the country, with just 48% vaccinated compared to the nationwide average of 60%, according to federal data through Aug. 1. Florida and Louisiana are last with 46% and 45% respectively.
At 82%, the rate among Missouri nursing home residents is better — the same as the national average. In Illinois, 85% of nursing home residents are vaccinated and 61% of staff.
The mandate brings some concerns among nursing home owners and workers.
The director of the Missouri Health Care Association, the state’s chief nursing home industry group, said members are worried the directive could send much-needed staff to places with no mandates such as some hospitals, adult day cares or assisted living facilities.
“There has been little information released thus far; therefore, we are still trying assess the specifics of this directive,” Nikki Strong said. “The reports we have read on this directive suggest that the mandate will only apply to nursing homes and not to other health care settings. If this is accurate, the singling out of nursing homes will only exacerbate the current crisis-level workforce shortages.”
Nearly 32% of nursing facilities in Missouri report a shortage of nurses or aides, according to recent data tabulated by the American Association of Retired Persons.
SEIU Healthcare, which represents workers across the Midwest and is Missouri’s largest health care workers union, issued a statement supporting the mandate but urged a “collaborative approach.”
The union called on employers to answer workers questions and concerns about the vaccines, and to provide workers with sick days and paid time off should they experience side effects from the shots.
“We support mandated vaccinations for health care workers in conjunction with a comprehensive education program as a means to better protect workers and care recipients …,” the statement read. “At the same time, we strongly urge health care employers to partner with the union and listen and respond to worker voices and worker needs in the implementation of vaccination mandates.”
In total, 3,683 residents and 47 staff members working in nursing homes and long-term care facilities in Missouri have died of COVID-19, according to an analysis of federal data by St. Louis University sociologist Chris Prener. That makes up 35% of all COVID-19 deaths reported in the state to date.
Michele Munz of the Post-Dispatch contributed to this report.
Donald J. Pavlacic, 83, was a customer service rep for what is now Ameren Missouri and a coach.