Jordan Rau - KFF Health News

Faced with a slow rollout of the updated vaccines and without state mandates for workers to get vaccinated, most skilled facilities are relying on persuasion to boost vaccination rates among staff and residents.

After the nursing home where Leann Sample worked was bought by private investors, it started falling apart. Literally. But the owners of the facility were making huge profits.

Federal officials said they are penalizing 2,273 hospitals, the fewest since the fiscal year that ended in September 2014. Driving the decline was a change in the formula to compensate for the chaos caused by the COVID-19 pandemic.

The president wants to set minimum staffing levels for the beleaguered nursing home industry. But, given a lack of transparency surrounding industry’s finances, it’s a mystery how facilities will shoulder the costs.

Among the 764 hospitals hit with a 1% reduction in payments for having high numbers of infections and avoidable complications are more than three dozen Medicare ranks among the nation's best.

The federal penalty program finishes its first decade by lowering payments to nearly half the nation’s hospitals for readmitting too many Medicare patients within a month. Penalties are credited with helping reduce the number of patients returning for another Medicare stay within 30 days.

Nursing home operators acknowledge that large numbers of staff members are not getting the shots but fear a federal vaccination mandate could drive away workers in a tight labor market.

A Kaiser Family Foundation poll finds two-thirds of parents support mandating masks for unvaccinated students, but resistance to vaccinating remains high. “My child is not a test dummy,” one parent says.

Those hospitals, which include several in Florida and some of the nation’s marquee medical centers, will lose 1% of their Medicare payments over 12 months.

The penalties are the ninth round of a program created as part of the ACA's broader effort to improve quality and lower costs.