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Nursing Home Workers To Face Vaccine Mandate

Nursing home vaccination
The mandate is expected to apply to more than 15,000 nursing homes nationally and is being pushed by the Biden administration as the highly contagious delta variant of the coronavirus has caused a spike in COVID-19 cases and hospitalizations.

The federal announcement that nursing homes relying on Medicaid and Medicare funding must require staff members to get vaccinated will have a ripple effect through Florida.

As COVID-19 cases continue to surge in Florida, the White House announced Wednesday that nursing homes that rely on Medicaid and Medicare funding must require their staff members to get vaccinated against the novel coronavirus.

The announcement will have a ripple effect through Florida, which has nearly 700 nursing homes. Groups that advocate on behalf of seniors had already been sounding the alarm about low vaccination rates among nursing home workers.

The mandate is expected to apply to more than 15,000 nursing homes nationally and is being pushed by the Biden administration as the highly contagious delta variant of the coronavirus has caused a spike in COVID-19 cases and hospitalizations.

Regulations will be published in September, according to a “fact sheet” the White House distributed Wednesday.

Tom Parker, director of reimbursement for the Florida Health Care Association, said Florida nursing homes rely heavily on Medicaid and Medicare to pay for resident care.

Parker called Medicaid an “essential” funding source for the state’s nursing homes, saying that on average it makes up about 51 percent of a facility’s funding. Medicaid is jointly funded by the state and federal governments and covers health-care costs of low-income residents, many seniors and people with disabilities.

Parker said Medicare, which is administered solely by the federal government, accounts for an additional 30 percent of revenue for Florida nursing homes. The other 19 percent, Parker said, comes from private insurance, the U.S. Department of Veterans Affairs and people who pay out of pocket.

As a result, the vaccination mandate will have a significant impact in Florida. Not only are providers reliant on the federal funding, Florida nursing homes had the second-lowest percentage of vaccinated workers in the country during a four-week period in June and July, according to an AARP analysis released last week.

Florida nursing homes reported data that showed on average 45.1 percent of workers had been vaccinated during the period from June 20 to July 18. Only Louisiana had lower vaccination rates.

The AARP analysis also showed that only 5.2 percent of the 691 licensed nursing homes in Florida reported that 75 percent or more of their staff had been vaccinated. That was the lowest percentage of nursing homes reporting 75 percent vaccination rates in the nation.

Gov. Ron DeSantis has been adamant in his opposition to mandates during the COVID-19 pandemic. DeSantis this month said he didn’t support hospitals requiring staff members to be vaccinated. The governor also has sought to prevent schools from requiring students to wear masks and has battled a cruise line in court over attempts to require passengers to show proof of vaccination.

But as the vaccines became available late last year, DeSantis also focused heavily on vaccinating seniors, including nursing home residents. COVID-19 is particularly dangerous to seniors and people with underlying medical conditions, and outbreaks in nursing homes have led to thousands of deaths.

The governor’s office did not immediately reply to News Service of Florida requests for comment on the Biden administration’s mandate for nursing-home staff vaccinations.

News of the mandate came after the state reported 23,335 new COVID-19 infections and eight additional deaths on Tuesday. Nationally, 141,893 new infections and 822 deaths were reported for the day.

Florida also reported that 17,096 patients with COVID-19 were in hospitals across the state and that they occupied more than 31 percent of inpatient beds.

The Florida Health Care Association, which represents about 560 nursing homes, will review the federal regulations about staff vaccinations when they become available, association spokeswoman Kristen Knapp said in a statement to the News Service.

“In the meantime, we continue to support our members as they work on increasing vaccination rates among staff, as we know the vaccine is one of the safest ways to protect against the virus,” Knapp said.

LeadingAge Florida, another long-term care association, also was waiting Wednesday to see additional details about the mandate. But Nick Van Der Linden, a spokesman for the group, said in a statement to the News Service that the association “has always strongly supported vaccinations for all residents and staff in long-term care settings. Our members have been moving in this direction on their own, and we have seen an increase in the number of providers that now have mandates in place.”

The Biden administration also announced Wednesday it will make booster shots available to the public beginning the week of Sept. 20. The plan is to make the booster shots available so people can receive them eight months after they received second doses of the Pfizer or Moderna vaccines.

A Centers for Disease Control and Prevention study released Wednesday shows the Pfizer and Moderna vaccines have become less effective in keeping nursing home residents safe as the delta variant of the coronavirus has spread.

The latest edition of the CDC publication “Morbidity and Mortality Weekly” shows that from March 1 to May 9, two doses of the Pfizer or Moderna vaccines were nearly 75 percent effective in keeping nursing home residents safe from COVID-19 infections. For the period from June 21 to Aug. 1, as the delta variant spread, the effectiveness of two doses of the vaccines dropped to 53.1 percent.

“Because nursing home residents might remain at some risk for (COVID-19) infection despite vaccination, multiple COVID-19 prevention strategies, including infection control, testing and vaccination of nursing home staff members, residents, and visitors are critical,” scientists wrote in the report. “An additional dose of COVID-19 vaccine might be considered for nursing-home and long-term care facility residents to optimize a protective immune response.”

In reaching their conclusions, scientists reviewed tens of thousands of reports submitted by nursing homes. They found that the Pfizer and Moderna vaccines became less effective over time and less effective as the delta variant became the dominant strain of the virus.

For instance, the two vaccines proved to be 74.7 percent effective in the period from March 1 to May 9; 67.5 percent effective from May 10 to June 20; and 53.1 percent from June 21 to Aug. 1. But scientists said they could not differentiate the impact of the delta variant on the effectiveness of the vaccines from other potential factors, including the dwindling of vaccine effectiveness over time.

“Further research on the possible impact of both factors on (vaccine effectiveness) among nursing home residents is warranted,” the study’s authors wrote.

Christine Sexton - News Service of Florida