Genesis HealthCare CEO Harry Wilson

Genesis HealthCare, the nation’s largest nursing home chain, has declared a “universal” COVID-19 vaccine policy for all employees, care partners and onsite vendors. They have three weeks to come into compliance.

The company made the announcement after the close of trading Monday. It is the biggest shoe to drop in a growing trend toward mandatory vaccinations for long-term care personnel.

Genesis is by far the largest single nursing home company in the country, with 357 facilities and nearly 42,000 skilled nursing beds, according to recent statistics from the American Health Care Association.

The new Genesis policy requires individuals to have a single dose of the Janssen vaccine or the first dose of a two-dose mRNA vaccine by Aug. 23. If applicable, the second mRNA dose would be needed by Sept. 22.

Genesis HealthCare CEO Harry Wilson

“Our move to adopt universal vaccination is an incredibly important decision, and we very seriously weighed the competing concerns before proceeding down this path,”  said Genesis CEO Harry Wilson in his first public comments since being named the head of the company earlier this year. 

The foremost concern cited by long-term care operators has been that employees set against getting vaccinated would leave their jobs or the profession altogether at a time where staffing shortages are already common. Wilson, however, said there are greater interests in play.

“Despite vaccination rates above the national average, the growing spread of the Delta variant makes clear that we need to increase our vaccination rates substantially to better protect our patients, residents and employees,” he said. “While we would have greatly preferred a strictly voluntary process, our commitment to health and safety outweighs concerns about imposing a requirement. Universal COVID-19 vaccination provides the safest and most effective course of action to ensure the health and welfare of our patients, residents and staff.”

There are two potential valid exemptions for an employee who chooses to decline the COVID-19 vaccine: medical or religious, a Genesis spokeswoman explained. If an exemption is not granted, the unvaccinated employee “may be subject to termination,” she added.

Despite a growing drumbeat for mandatory vaccinations, especially among healthcare workers, the topic has been controversial. AHCA, the nation’s largest nursing home association last week came out in support of providers who may be imposing vaccinations as condition of employment — but it did not outright call for providers to mandate vaccinations.

On the other hand, the nation’s second-largest nursing home association, LeadingAge, was part of a coalition of nearly 60 groups that early last week called for mandatory vaccinations of all healthcare workers. 

Wilson said that a voluntary company vaccination program began in December 2020, emphasizing “communication, engagement and trust-building.” It has netted “above average” conversion rates of 85% for patients and 65% for staff. But more is needed, he said in the company statement.

“Due to age, underlying conditions, or both, nursing home patients and residents are at greater risk of severe illness if they contract COVID-19,” Wilson noted. “This threat can be reduced significantly through universal COVID-19 vaccination.”

The company statement said that it supports AHCA’s “call for ‘all healthcare and long-term care employers to require their employees to be vaccinated against COVID-19 …’ ” An AHCA spokeswoman Tuesday morning, however, confirmed the association’s less stringent stance from last week.

The Genesis statement called making vaccinations a condition of doing business “the logical fulfillment of the ethical commitment of all healthcare workers to put patients as well as residents of long-term care facilities first and take all steps necessary to ensure their health and well-being.” Nonprofit long-term care giant Good Samaritan, the fifth-largest nursing home company in the U.S., announced its mandatory vaccination policy July 22.

According to its website, Genesis is a holding company with subsidiaries operating 400 skilled nursing facilities and senior living communities in 26 states. Subsidiaries also supply rehabilitation therapy to approximately 1,200 locations in 46 states and the District of Columbia. Overall, Genesis subsidiaries employ approximately 70,000 people. The website notes that Genesis features skilled nursing, memory care, assisted living and independent living facilities. The company offers cardiac management, onsite dialysis care, mental health and recovery, neurorehabilitation, ventilator care, VA-contracted care, pulmonary and transitional services and more.