In a significant escalation of the federal government’s effort to increase vaccination rates, President Biden announced today that he has directed the Centers for Medicare & Medicaid Services (CMS) to develop regulations requiring all nursing homes to mandate COVID-19 vaccinations for their staff, as a condition of receiving federal Medicare and Medicaid funding.

The White House framed its announcement of this sweeping action with reference to spread of the Delta variant, a rise in the number of COVID-19 cases across the country, and data showing a relationship between the increase of COVID-19 cases among nursing home residents and the rate of vaccination among nursing home workers.

To implement the directive, CMS will develop an emergency regulation, which the agency expects to release in September according to a press release. CMS has not released details of its intended policy in writing, leaving us without information at this time about a number of key issues:

• Effective Date:  How much lead time will facilities and their employees have before the requirement takes effect? CMS has said it will complete its rule-making activity over the course of the next several weeks, but has not indicated what the effective date of the requirement will be.
• Scope: Will CMS impose a strict mandate, or will it provide any flexibility or alternative protective measures (such as increased testing) that may be applied to unvaccinated employees? There was no indication of flexibility in today’s announcement, but we are not able to confirm CMS’s approach until the agency provides more information.
• Accommodations: If the rule sets a strict mandate, what exemptions or accommodations will employees be allowed to request?
• Enforcement: How will CMS enforce the requirement? Will there be financial penalties?

Since news of the President’s decision emerged earlier today, we have heard from many of you expressing concern about the potentially devastating impact this policy may have on your workforce. That impact is among many repercussions we will assess in the days to come.  Among other issues, we understand the mandate will apply only to nursing homes, and not to assisted living or other healthcare settings, and we need to understand the workforce impact of this sole focus on nursing homes.

We will do everything we can, working with the LeadingAge team, to advocate for CMS to provide as much flexibility as possible in the implementation and enforcement of this new policy.  Our team will provide more information to members as soon as it becomes available, and we will share the latest information we have during our Friday at 11 a.m. on the LeadingAge Minnesota Huddle. Register in advance to join the conversation.