As vaccination rates for nursing homes residents remain too low and case rates have been steadily climbing, the federal government is implementing programs to help providers vaccinate their residents with the latest boosters – although no programs are as drastic or proactive as when the first vaccines were released.
“The rates have been steadily climbing, but this number is still too low as we head further into the winter months and face new variants of COVID-19,” said CMS Administrator Chiquita Brooks-LaSure during Thursday’s National Nursing Home Stakeholder Call. “Getting your residents up-to-date on vaccines needs to remain your number one priority.”
Still, the onus is largely on providers to find the best kind of vaccination program for their facilities.
Officials stressed that there are a variety of supports available to help facilitate vaccinations for nursing home residents and staff, of which, according to Kaiser Family Foundation research, only 45% and 22% respectively are up-to-date with their COVID-19 vaccines.
“Last year, we saw the largest spike in COVID-19 cases and deaths in January and February, and so we want to do everything we can to avoid negative health outcomes as we enter these winter months,” Brooks-LaSure said.
During the call, CDC Medical Officer Dr. Sarah Meyer said that for operators not already directly enrolled as providers in the CDC COVID-19 vaccination program, there is a new option to sign a sub-provider agreement with CDC to administer vaccines in their facilities. A key component of this program is the use of single-dose Pfizer vials, which facilities that have signed a sub-provider agreement with CDC can request through pharmacy partners.
“This was intended to help remove some of the barriers that we heard about that storage and handling of multi-dose vials is more difficult because there’s not always large groups of patients who want a vaccine at one given time,” Meyer said. “So it allows [facilities to administer vaccines] one-by-one as patients are ready to take the vaccine.”
There are also some adjusted data reporting flexibilities built in, so facilities that sign a sub-provider agreement have a 90 day temporary waiver of data reporting requirements to the IHS unless it is required by state laws.
“They would still need to report through any other required mechanisms such as NHSN but we do still encourage people to facilities to report to the IAS voluntarily if they’re able to,” she said. “I think we all recognize the power that data has to use for action in helping to increase our vaccination efforts.”
AMDA, The Society for Post-Acute and Long-Term Care Medicine, in December released a toolkit which CMS officials said would help providers find information on vaccination programs and how to address vaccine hesitancy.
“Our quality improvement organizations have been reaching out to facilities with the lowest up-to-date rates to offer technical assistance and to help coordinate on site vaccination clinics,” Brooks-LaSure said. “I really hope you will take these groups up on these offers and you’ll hear more on this call about the resources that are available to help you in this effort.”
Some skilled nursing operators have expressed frustration with the hospital system for discharging new patients to nursing facilities without ensuring they are fully boosted. CMS Chief Medical Officer Dr. Lee Fleisher said the agencies will continue to work with hospital associations to find solutions.
“We are talking to the hospital associations and trying to push them to continue vaccinating. Some of them answer that it may not be the right time [for patients] to get vaccinations,” Dr. Fleisher said. “But then, if there’s that’s reason, it wouldn’t be the right time to vaccinate when they to come into the nursing home because they are immunosuppressed or there are other conditions preventing vaccination.”
CMS Nursing Home Director Evan Shulman said that beyond vaccinations, the agency will be focusing on new requirements implemented in October 2022, which include updates to minimum health and safety standards, Medicare and Medicaid participation requirements, and new guidance in the State Operations Manual.
“We want to continue to get back to normal to get back to the things that are outside of COVID that we do every day,” he said.
