Biden’s No-Jab-No-Job order creates dilemma for nursing homes

Jordan Rau and Andy Miller / Kaiser Health News (TNS)

President Joe Biden’s edict that nursing homes must ensure their workers are vaccinated against COVID-199 presents a challenge for an industry struggling to get its lowest-paid workers to get vaccinated without encouraging them to seek employment elsewhere.

Although 83% of residents in an average nursing facility are vaccinated, only 61% of workers in a home are likely to be, according to data submitted by homes and released by the Centers for Medicare & Medicaid Services. to the week ending August 8. More than 602,000 staff members have contracted COVID-19 and more than 2,000 have died from it.

This led Biden to say on Wednesday that the government would require vaccination of employees as a condition for nursing homes to receive reimbursements from Medicare and Medicaid, which account for most of the industry’s revenue.

“Over 130,000 nursing home residents have sadly died during the time of this virus,” Biden told reporters. “At the same time, vaccination rates among nursing home staff are significantly lower than in the rest of the country.”

Nursing homes in Florida and Louisiana have the lowest average staff vaccination rates among the states, with 46% of facility workers fully vaccinated. Rates are highest in Hawaii, with an average of 87% of workers vaccinated per facility, and California, with 81% vaccinated on average, the data shows.

The American Health Care Association, a nursing home lobby, said it appreciates the order but the mandate should also apply to other health care providers so that workers who refuse vaccination don’t have no reason to change jobs within the industry.

“Focusing only on nursing homes will cause workers hesitant about vaccination to flee to other health care providers and leave many centers without adequate staff to care for residents,” said Mark Parkinson, president and CEO of the association, in a press release. “This will further exacerbate an already difficult labor shortage. “

David Grabowski, professor of health care policy at Harvard Medical School, said that since many nursing assistants are paid only minimum wage or slightly more, they would be more likely to seek work in retail establishments. by retail. “The risk is not that they go to the hospital down the street – the risk is that they go to Starbucks or Target,” he said in an interview. “It’s great if you want to impose the vaccine, but you also want to make sure these workers earn a living wage. “

Jon Green, CEO of Pinewood Manor Nursing and Rehabilitation in rural Hawkinsville, Georgia, said that “vaccines are needed to control the virus,” but “if we had mandated it ourselves, it would have caused [many workers] leave. ” His establishment, which is a non-profit house, has around 85 employees.

Just over half of nursing home workers in Georgia, on average, are vaccinated.

Some facilities have already imposed vaccination requirements on employees, including PruittHealth, a large chain of nursing homes in the South. The company has set a deadline of October 1 for employees to receive at least an initial dose of the vaccine. About 45% of the workforce in its nursing homes received an injection. PruittHealth said only medical and religious exemptions to its vaccine mandate will be considered on a case-by-case basis.

Lori Smetanka, executive director of Consumer Voice, a nonprofit that advocates for people receiving long-term care services, said if nursing homes were successful in getting more employees to accept vaccines, it It might be easier for them to retain and recruit other people who were afraid of catching COVID-19 in homes.

“We saw that a number of workers early enough in the pandemic quit because they were concerned for their own safety,” Smetanka said. “It’s an opportunity to attract people who didn’t want to work in the facilities. “

CMS said it would issue an emergency rule in the coming weeks that would add staff vaccination to nursing home requirements to receive Medicare and Medicaid reimbursements. This rule would presumably set out the criteria for compliance.

In practice, nursing homes are rarely excluded from Medicare and Medicaid programs for violating government participation requirements. The government usually gives institutions multiple opportunities to correct violations before proposing termination, even when institutions have repeatedly flouted the rules.


(KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with Policy Analysis and Polling, KHN is one of the three main operational programs of KFF (Kaiser Family Foundation). KFF is a nonprofit staffed organization providing information on health issues to the nation.)

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