Nursing Homes Will Have to Vaccinate Workers or Risk Losing Federal Funding

Nursing home staff must be fully vaccinated from COVID-19 or jeopardize federal Medicare or Medicaid funding for their facilities, President Joe Biden announced last week.

The regulation could take place as soon as September and it will target more than 15,000 skilled nursing facilities that rely on federal funding.

Experts say the mandate is a positive step in fighting the pandemic as nursing homes have been hard hit with COVID-19 cases and deaths, but it may push workers to leave their job instead of getting vaccinated.

Mark Lawerence, a skilled nursing home administrator and owner of Oakmont Assisted Living Home in Scottsdale, Arizona, says he worries that the requirement is not broad enough.

“When this mandate was announced, one of the first things that concerned me was that it's not a universal mandate, it's not widespread, and it's going to create some winners and losers,” Lawrence tells Verywell.

Employees at nursing homes and assisted living facilities often work year-round, for long hours, and with low pay, he adds. Because of the mandate, he fears some staff will be inclined to seek work elsewhere rather than getting vaccinated.

“The challenge to recruit and retain competent employees at all levels, from caregivers up through nurses, is a real challenge for all of the providers out there,” Lawrence says.

Oakmont does not rely on Medicare and Medicaid funding, he adds.

“I wish it included all healthcare providers,” Lawrence says. “That would eliminate the concern I have about people job hopping and job searching, and it would just be a consistency—something like the annual flu shot.”

According to the Centers for Medicare & Medicaid Services, over 133,000 nursing home residents have died from COVID-19, accounting for nearly a quarter of the total pandemic fatalities nationwide. Currently, over 80% of the residents and about 60% of the staff at long-term care facilities are vaccinated.

Lawrence says the mandate is a step in the right direction, even if it only targets federally-funded facilities. At Oakmont, losing patients to COVID-19 in the early months of the pandemic was especially devastating for Lawrence and his staff. “It’s like losing a friend,” he says.

“Normally in healthcare, you see people decline, and you're prepared for that. You knew their underlying conditions,” Lawrence says. “With COVID, it all hit at once.”

Lawrence adds that he's not too concerned about vaccine hesitancy at his own facility, as all patients and staff have voluntarily agreed to get vaccinated against COVID-19.

Sachin Nagrani, MD, medical director for Heal, a health organization that provides at-home visits to older adults, tells Verywell that vaccine mandates can be tricky. He says that employers have the challenge of encouraging their employees to get vaccinated out of willingness rather than “as a condition of employment.”

Vaccination rate among healthcare workers is high, he adds, but it’s harder to mitigate the risks involved with unvaccinated family members who frequently visit those elderly homes. 

“We've had the vaccine available for a few months now, widely available, and the Delta variant has been ramping up,” he says. “The push is really to make sure that as many people who are in the nursing homes are vaccinated as possible because they are at higher risk for hospitalization and death.”

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