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Biden to Make Nursing Homes Vaccinate Staff to Get Funding (1)

Aug. 18, 2021, 11:27 PMUpdated: Aug. 18, 2021, 11:24 PM

President Joe Biden announced Wednesday that his administration will require nursing homes to vaccinate their staff against the coronavirus in order to receive federal funding.

The new requirement will apply to more than 15,000 facilities that currently participate in the Medicare and Medicaid programs. As many as 1.3 million people working in nursing homes would fall under the new requirement, according to estimates by the Biden administration.

The announcement was part of a series of steps the president and his administration laid out Wednesday as they seek to rein in a sharp increase in the number of Covid-19 cases and deaths wrought by the highly transmissible delta variant.

The White House has said it is searching for ways to leverage federal funding to encourage more Americans to get vaccinated as the delta variant surges and only 77.2% of the adult population in the U.S. has received at least one dose of the vaccine. Vaccination rates among nursing home staffers have trailed that number.

“The data are clear that higher levels of staff vaccination are linked to fewer outbreaks among residents, many of whom are at an increased risk of infection, hospitalization, or death,” Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure said in a statement.

The CMS said it strongly encourages nursing home residents and staff members to get vaccinated as it works through the rulemaking process over the next several weeks.

Predicting Staffing Shortages

The nursing home industry is projecting the vaccination requirement for nursing home workers will result in widespread staffing shortages.

The president of the industry’s largest trade group, which has steadfastly opposed mandatory staff vaccinations, said the government is singling out nursing homes when all health-care workers should face the same requirement.

“Focusing only on nursing homes will cause vaccine hesitant workers to flee to other health care providers and leave many centers without adequate staff to care for residents,” said Mark Parkinson, president of the American Health Care Association, said in a statement Wednesday. “It will make an already difficult workforce shortage even worse.”

Katie Smith Sloan, president of LeadingAge, which represents nonprofit nursing homes and other aging services providers, previously had voiced support for making staff vaccinations a condition of employment. But in a statement Wednesday, she said threatening the loss of federal Medicare and Medicaid funding is the wrong approach to increase employee vaccination rates.

“Our mission-driven nursing home members, who operate on narrow margins in the best of times, depend on those funds alone to care for their residents,” Sloan said. “They cannot bear additional financial losses after more than a year of shouldering historic COVID-related costs.”

Evidence shows employer vaccine mandates work, said Ann Marie Pettis, president of the Association for Professionals in Infection Control and Epidemiology. Influenza vaccination rates increased from nearly 70% to more than 90% after they became required for nursing home workers, she said.

“With the increased spread of the Delta variant and more than 40% of nursing home staff still unvaccinated, action needed to be taken to protect residents, healthcare providers, and their families,” Pettis said.

Epicenter of Outbreak

Nursing homes and other long-term care facilities have been the epicenter of the Covid-19 outbreak, accounting for nearly 187,000 deaths and more than 1.4 million infections as of July 30, according to the Kaiser Family Foundation. Infected staffers are believed to be the cause of many of the illnesses and deaths.

The Delta variant has driven a rise in cases among nursing home residents from 319 cases on June 27, to 2,696 cases on Aug. 8, the CMS said. Many of the recent outbreaks in nursing homes have occurred at facilities in areas of the country with the lowest staff vaccination rates, the agency said.

Nationally, about 60% of nursing home workers were vaccinated as of Aug. 12, federal data show. State-level vaccination rates for nursing home staff range from a high of 88% in Hawaii to a low of 44% in Louisiana.

Nearly 2,000 nursing home staffers have died of Covid.

To contact the reporters on this story:
Justin Sink in Washington at; Tony Pugh in Washington at

To contact the editors responsible for this story:
Alex Wayne at, Brent Bierman, Joshua Gallu, Justin Blum

© 2021 Bloomberg L.P. All rights reserved. Used with permission.

(Updated with additional reporting throughout.)