The Biden administration on Thursday unveiled a sweeping new COVID-19 vaccination rule that would require about 17 million health care workers across 76,000 hospitals, nursing homes and other health care facilities to get fully immunized by Jan. 4.
The vaccine mandate for health workers and an accompanying one for businesses with 100 or more employees aims to reduce the ranks of the unvaccinated, prevent workers and customers from getting sick and spur the economy by encouraging millions of Americans to return to work.
Unlike the companion mandate for private businesses, health care workers who refuse vaccination won’t have the option of getting tested in lieu of immunization. Citing “higher bar” for health facilities because of their critical role in ensuring the health and safety of patients, President Joe Biden’s plan will allow only health care workers who qualify for a medical or religious exemption to skip the immunization, a senior administration official said.
The new rule requires employees of health care facilities to be fully vaccinated with either two doses of Pfizer or Moderna, or one dose of the Johnson & Johnson vaccine by Jan. 4.
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The mandate applies to all facilities that take payments from Medicare or Medicaid, including hospitals, nursing homes, dialysis centers, ambulatory surgical centers and home health agencies. It applies to clinical workers such as doctors and nurses directly involved with patient care, and also nonclinical employees, students, trainees, and volunteers as well as contract employees who provide treatment or other services.
The Centers for Medicare and Medicaid Services will enforce the mandate through routine inspections, or surveys, of the facilities that participate in the federal insurance programs. Facilities that don’t meet the vaccine mandate can be cited or fined but will be given multiple chances to improve vaccination compliance, officials said.
The federal regulations aim to ensure health providers comply with the new vaccine mandate. “It is not to punish workers for health care facilities. However, we will not hesitate to use our full enforcement authority to protect the health and safety of patients,” a senior administration official said.
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The new regulation stems from Biden’s announcement in September that all hospitals and health facilities that take Medicare and Medicaid reimbursement must vaccinate their workers.
States such as New York and California already have enacted mandatory vaccination for health care workers, and some hospitals have dismissed or suspended workers who have refused to comply. Only a small percentage of workers have quit or been dismissed over vaccine refusal.
CMS Administrator Chiquita Brooks-LaSure said large hospitals and other health facilities that have mandated vaccines have seen dramatic increases in immunization rates. Trinity Health, a large Catholic health system in 22 states, increased its vaccination rate from 75% to 96% after mandating shots for workers.
“When we look at the data, particularly in nursing homes where people live, we know how vital it is to make sure that patients are safe,” Brooks-LaSure said. “And one of the things that’s going to protect people more than ever is to make sure that all the health care workers are vaccinated.”
While health leaders acknowledge and support mandatory vaccination, some worry workforce disruptions could punctuate a widespread shortage of health care workers at hospitals and clinics nationwide. The number of health job openings swelled during the pandemic with the Bureau of Labor Statistics reporting 1.8 million health care openings as of July, up from 1.1 million open jobs in July 2020.
Rural hospitals had chronic doctor and nurse shortages before the pandemic began, and some worry workforce shortages could worsen under a federal vaccination mandate.
The National Rural Health Association “believes it is important for all healthcare workers to be vaccinated, to protect both themselves and their community,” CEO Alan Morgan said. “However, vaccine mandates will result in rural service disruptions. And as such, targeted rural federal workforce plans must be communicated and implemented.”
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Staffing agencies that provide nurses and other temporary health care workers said requests from hospitals have surged during the pandemic. And once the Biden mandate kicks in for hospitals, requests for contract nurses are likely to go higher to fill vacancies amid a nationwide labor shortage, agencies said.
The American Hospital Association earlier said it “strongly supports” mandatory vaccination but urged the Biden administration’s policy to be “feasible, transparent and fair” for all health providers subject to the mandate.
The group, which represents nearly 5,000 hospitals and health systems, said any vaccine mandate should apply to all Medicare-regulated health care providers. The group also urged enough time to comply with the mandate and a progressive enforcement approach to give health facilities multiple opportunities to meet the mandate.
As of late September, more than 2,500 hospitals and health systems announced mandatory vaccination policies. Hospitals faced a patchwork of state regulations on vaccines and some facilities delayed vaccine requirements until learning what the Biden administration would require.
Ken Alltucker is on Twitter as @kalltucker or can be emailed at [email protected]