Skilled Nursing Facility Vaccination Mandate: Exacerbating Staffing Shortages and Turnover
A new regulation by the Centers for Medicare & Medicaid Services (CMS), effective September 30, 2021, will require all staff in Medicare and Medicaid participating long-term care facilities to be vaccinated against COVID-19.1,2 Data suggests that the higher the rate of vaccination among staff, the lower the risk of an outbreak.
According to a June 2021 American Healthcare Association (AHCA) survey, 94% of nursing homes are currently facing staffing shortages, with 73% reporting a worsening of the situation since the end of 2020.3 Staffing shortages and high turnover have compounded the impact of COVID-19, and an excess of non-COVID-related deaths [due to neglect] have been reported.4
Currently, an estimated 62.7% of U.S. Skilled Nursing Facility (SNF) staff are vaccinated; it’s unclear whether the data is for complete or partial immunization.5 Comparable figures for U.S. adult figures estimate that 54.0% are fully vaccinated and 63.3% are partially vaccinated.6 According to the Kaiser Family Foundation Vaccine Monitor, attitudes among the non-vaccinated population regarding receiving the vaccine broke down as follows: “as soon as possible” (4%), “wait and see” (12%), “only if required” (7%) and “definitely not” (13%).7 As of September 2021 sixteen states, lag the national partial vaccination rate by approximately ten percentage points or more.8 Compliance with the CMS regulation will be most challenging for nursing homes in these states.
1: Biden-Harris Administration Takes Additional Action to Protect America’s Nursing Home Residents from COVID-19. Centers for Medicare & Medicaid Services; August 18, 2021. https://www.cms.gov/newsroom/press-releases/biden-harris-administration-takes-additional-action-protect-americas-nursing-home-residents-covid-19
2: Amy Stulick, “Nursing Home Staff Must Be Vaccinated, Biden Administration Says.” Skilled Nursing News; August 18, 2021. https://skillednursingnews.com/2021/08/bidenadministration-expected-to-mandate-covid-19-vaccines-for-nursing-home-staff/
3: State of Nursing Home and Assisted Living Industry: Facing Workforce Challenges. AHCA/NCAL; June 2021. https://www.ahcancal.org/News-and-Communications/Fact-Sheets/FactSheets/Workforce-Survey-June2020.pdf
4: Matt Sedensky and Bernard Condon, “Not just COVID: Nursing home neglect deaths surge in shadows.” AP News; November 19, 2020. https://apnews.com/article/nursing-homesneglect-death-surge-3b74a2202140c5a6b5cf05cdf0ea4f32
5: COVID-19 Nursing home data. Centers for Medicare & Medicaid Services. https://data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bkwz-xpvg/
6: Mayo Clinic Covid Vaccine Tracker. August 25, 2021. https://www.mayoclinic.org/coronavirus-covid-19/vaccine-tracker
7: KFF COVID-19 Vaccine Monitor: May 2021. May 28, 2021. https://www.kff.org/report-section/kff-covid-19-vaccine-monitor-may-2021-findings
8: Mayo Clinic U.S. COVID-19 Vaccine Tracker. August 25, 2021. https://www.mayoclinic.org/coronavirus-covid-19/vaccine-tracker