Providers, organizations await details on federal vaccine requirement

Those in the healthcare industry say they are awaiting more information on the new federal vaccine requirement for healthcare workers, which is expected to be issued as an interim final rule by the Centers for Medicare and Medicaid in October.

While many healthcare groups have expressed support of mandatory vaccinations, some have noted concern that a requirement could worsen the staffing shortage.

Alan Levine, chairman and CEO of Johnson City, Tennessee-based Ballad Health, who has previously expressed hesitation about vaccine mandates tweeted that the system won’t react until it sees the language in the rule.

“Ballad Health supports vaccinations but has had concerns about mandates leaving us with too few nurses to care for the volume of patients we have,” Levine said.

Likewise, the Minnesota Nurses Association Board of Directors said it supports “voluntary vaccine programs.

“After years of deliberate under staffing, increasing threats of workplace violence and lack of autonomy over their profession, the same healthcare workers who have been caring for us in our darkest hours are exhausted and leaving the profession early or for less demanding work. We question the timing of the impending vaccine mandates and believe these mandates will continue to exacerbate staffing shortages,” the Minnesota Board of Directors said in a statement.

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The Biden administration on Thursday expanded its COVID-19 vaccine requirements to include all healthcare workers at facilities that receive Medicare or Medicaid funding in an effort to lessen the spread of the Delta variant. Previously, the mandate only covered nursing home workers but now includes staff at hospitals, dialysis facilities, ambulatory surgical settings and home health agencies, among others.

HCA Healthcare as recently as Thursday had said it was not mandating COVID-19 vaccinations for its workers. But that was before President Joe Biden announced the new requirement for healthcare staff. HCA said it would review the details of the requirement and respond accordingly. The company said it follows guidance from the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration.

The Cleveland Clinic, which previously has not implemented a vaccine mandate, said 80% of its employees already are vaccinated.

“The COVID-19 vaccines are safe and effective and are the best way to protect individuals from severe illness or death from the virus,” the Cleveland Clinic said in a statement. “We are awaiting more information and plan to comply with federal requirements.”

The new federal requirements are expected to cover about 50,000 providers and most of the healthcare workers in the country, the White House said. CMS expanded the vaccine requirement after finding that nursing homes with staff vaccination rates of 75% or lower have higher rates of COVID-19 infections.

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“There is no question that staff, across any healthcare setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health. Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential,” Department of Health and Human Services Secretary Xavier Becerra said in a statement.

National Nurses United, a union of more than 175,000 registered nurses in the U.S., said it has advocated since the beginning of the pandemic for multiple infection control measures, including vaccination, to be taken.

“With high rates of COVID transmission across the country, NNU praised President Joe Biden for taking further action to stop the spread of the deadly and highly contagious Delta variant,” NNU said in a statement.

The union said “vaccination is a critically important part of a comprehensive public health program for infection control” but not the only one. NNU also called for public and workplace infection control measure like routine testing, contact tracing, masking in public settings despite vaccination status and social distancing, as well as providing healthcare workers with adequate personal protective equipment and safe staffing levels.

Ernest Grant, president of the American Nurses Association, which represents 4.3 million registered nurses, said the ANA supports the Biden administration’s “plan to use every lever to increase the number of people vaccinated as the only way to get out of this crisis.”

“ANA applauds the Biden Administration for using its full authority to increase our nation’s COVID-19 vaccination rate and put the pandemic behind us,” Grant said in a statement. “In addition, we look forward to working with them to address the underlying systemic problems of nurse staffing shortages that with the pandemic have created a national crisis for the nation’s nursing workforce.”

Bill Dombi, president of the National Association for Home Care and Hospice, which represents 33,000 home care and hospice organizations, said NAHC has encouraged vaccinations throughout the pandemic.

“We look forward to seeing the details of the President’s Executive Order,” Dombi said

Those in the nursing home industry support expanding the requirement to cover all healthcare workers and say it will help keep workers from leaving the field.

Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living, which represents more than 14,000 nursing homes and long-term care facilities, said nearly 4,000 providers had expressed their concerns about a vaccine requirement limited to nursing home workers.

“We applaud President Biden for expanding COVID-19 vaccination requirements to all Medicare and Medicaid-certified healthcare settings, as well as larger businesses. This will help prevent unvaccinated nursing home staff from looking for new lines of work, alleviating some of the staffing challenges too many long-term care facilities are currently facing,” Parkinson said.

LeadingAge, which represents more than 5,000 nonprofit aging services providers, also supported the administration’s decision to broaden its nursing home worker vaccine mandate to include all healthcare staff at Medicare and Medicaid funded facilities.

“Ensuring that all frontline health care staff are vaccinated just makes sense,” Katie Smith Sloan, president and CEO of LeadingAge, said in a statement. “This action not only shores up protection for older adults who move across care settings but also levels the playing field among providers competing for in-demand health care workers.”