[UPDATED] Nursing Homes No Longer Alone As Federal Mandate Expands

Redoubling efforts to vaccinate frontline health care workers against COVID-19 and its variants, President Joe Biden on Thursday expanded staff vaccination requirements to include any provider that receives Medicare or Medicaid funding.

The move is part of sweeping efforts affecting upwards of 100 million Americans — employers with more than 100 workers will be required to mandate the vaccine or test employees for the virus weekly.

Misty Reid, chief nursing officer and nurse practitioner for Vancouver, Wash.-based operator EmpRes Healthcare Management, called the administration’s move a “blessing” for the industry.


“Honestly, I think we were all very nervous that if this wasn’t reconsidered and expanded to include hospitals, in an industry that’s already extremely staff challenged, that was going to be the nail in the coffin for a lot of us,” said Reid. “A lot of our staff would have just went to other places that are not mandating.”

The initial announcement on Aug. 18 specific to skilled nursing facilities was part of a broader six-part plan to fight the pandemic via vaccine requirements, with federal funding on the line.

Thursday’s executive order expands the mandate to any provider that receives Medicare or Medicaid funding, including hospitals, home-health agencies, ambulatory surgical settings and dialysis centers, among others.


Lori Porter, co-founder and CEO of the National Association of Health Care Assistants (NAHCA), doesn’t expect the expansion to mitigate the loss of certified nursing assistants (CNAs) or other frontline staff.

“According to the U.S. Census Bureau – in 2018 – companies with fewer than 100 employees accounted for 98.1 percent of American companies. There will still be plenty of options – many with better pay and benefits – for CNAs willing to leave their profession due to the federal vaccine mandates,” the organization said in a statement.

About 80 million adults remain unvaccinated, White House press secretary Jen Psaki said during a press briefing preceding Biden’s speech.

Nursing homes with 75% or lower staff vaccination rates experience higher preventable COVID infection, according to a statement released by the Centers for Medicare & Medicaid Services (CMS), also noting low rates among hospitals and end stage renal disease (ESRD) facilities.

CMS Administrator Chiquita Brooks-LaSure maintained that the best defense against the Delta variant “lies with the COVID-19 vaccine.”

“Data show that the higher the level of vaccination rates among providers and staff, the lower the infection rate is among patients who are dependent upon them for care,” Brooks-LaSure said a statement. “Now is the time to act.”

“There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health. Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential,” U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra said in the same statement.

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) said it applauded Biden’s expansion efforts to Medicare and Medicaid-certified health care settings, along with larger businesses.

“This will help prevent unvaccinated nursing home staff from looking for new lines of work, alleviating some of the staffing challenges too many long-term care facilities are currently facing,” Mark Parkinson, president and CEO of AHCA/NCAL said in a statement following Biden’s speech. The lobbying group represents more than 14,000 non-profit and proprietary skilled nursing facilities, assisted living communities, sub-acute centers and homes for individuals with intellectual and developmental disabilities.

Added Parkinson: “Nearly 4,000 providers expressed their concerns about a federal mandate only for nursing home staff, and we appreciate the Administration listening to those concerns and applying this policy more broadly.”

Initiatives to boost vaccinations and testing access are also part of the plan, along with vaccination requirements for executive branch employees, with no testing alternative.

Booster shots starting Sept. 20 for those that got their shot eight months prior, along with using available tools to reopen schools, extend federal reimbursement to states for eligible COVID-19 emergency response costs and mobilizing National Guard personnel were other aspects of the six-part plan.

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