State and Federal Nursing Home Vaccine Mandate

On August 18, 2021, President Biden announced that nursing home staff must be fully vaccinated against COVID-19 in order for their respective facilities to receive federal Medicare and Medicaid funding. An official policy has not been released; however, the Centers for Medicare & Medicaid Services (CMS) is working on an emergency regulation to be released by the end of September. According to CMS, currently 61% of nursing home staff are vaccinated nationwide.

The Biden administration’s announcement comes amid a surge in the Delta variant, which now accounts for 99% of COVID-19 cases in the United States. Additionally, data shows a correlation between low employee vaccination rates in nursing homes and increasing coronavirus cases among residents. Cases in nursing home residents have spiked from a low of 319 on June 27 to nearly 2,700 on August 8, according to CMS. Many are in facilities with the lowest staff vaccination rates.

Even though a federal vaccine mandate for nursing home staff has just been announced, there are states that already have COVID-19 vaccination/testing regulations in place for nursing homes and/or healthcare settings. There are six states that require health care workers to be vaccinated or face termination. There are fifteen states that have a regulation for health care workers to either be vaccinated or be tested regularly. On the other hand, there are nine states that ban a vaccine mandate for employees.

Of the states mentioned above that have a policy for vaccination, four of them only apply to long-term care/nursing homes. Those states are Washington, Massachusetts, Mississippi, and Connecticut. It remains to be seen whether the federal vaccine mandate will apply to all health care settings or strictly nursing homes. There are staffing concerns within the industry because the mandate only applies to nursing homes currently. Due to this concern, a few states have considered and/or announced that their own state vaccine mandate will now apply to all health care settings.

Many states allow exemptions from the vaccine requirement for individuals with medical restrictions or sincerely held religious beliefs. The deadline to meet the vaccine requirement within states that have implemented mandates ranges from August 2, 2021, to October 31, 2021. Many states require health care staff to receive their second dose two weeks before their deadline to be considered fully vaccinated.

While the nation awaits the official federal vaccination policy for nursing homes from CMS, many local, city, and state regulations are beginning to take effect.