Long-term care facilities in only four states have reached a 75% staff vaccination goal set by the industry this winter, according to the latest data from the Centers for Medicare & Medicaid Services.

CMS began releasing weekly operator-reported vaccination data for LTC residents and staff members in June. As of the week ending June 13, the states with the highest reported rates of staff vaccination are Hawaii, Vermont, Alaska and California, with rates ranging from 83% to 75%. U.S. territory Puerto Rico, meanwhile, reported a 93% staff vaccination rate.

States with the lowest staff vaccination rates currently are Florida, Missouri, Mississippi and Lousisiana, ranging from 44% to 41% respectively, CMS reported.

The American Health Care Association and LeadingAge in February set June 30 as the goal date for achieving this level of staff vaccinations, prompted by the understanding that LTC staff are a key vectors of COVID-19 transmission inside facilities, and have historically low uptake of other vaccinations, such as influenza shots. AHCA’s sister, the National Center for Assisted Living, later joined the organizations’ #GetVaccinated campaign, which additionally now is supported by Argentum, the American Seniors Housing Association, LeadingAge, AMDA –The Society for Post-Acute and Long-Term Care Medicine and the National Hispanic Medical Association.

An early February report by the Center for Disease Control and Prevention found just 37.5% of nursing home staff members received at least one dose during the first month of the federal COVID-19 vaccine program. Residents had averaged more than double that.

With the CMS enforcing the weekly LTC vaccination reporting requirements as of June 14, local news outlets have begun covering the resulting stories, with nursing home administrators touting or bemoaning their state’s rank.

The Grand Forks Herald, for example, reported that St. Gerard’s Community of Care, a 37-bed skilled nursing facility in Hankinson, ND, has reached 93% staff vaccination rate, whereas North Dakota’s overall rate is 59%, according to CMS.

“Most likely, if there is COVID coming into the facility and infecting our residents, it’s coming from our staff,” Administrator Jill Foertsch told the news outlet. “We need to protect our residents. They’re the most vulnerable, the weakest, get hit the hardest … so that’s why it’s so critical that our direct caregivers and supplementary caregivers are vaccinated and educated in proper protocols for infection control.”

CMS does not collect vaccination data from assisted living operators, although it is considering doing so.

Editors note: An earlier version of this story mistakenly named Arkansas as one of the four states with the highest rate of staff vaccinations. The correct state is Alaska.