Singling out the long-term care industry with the federal COVID-19 vaccine mandate could cause a “mass exodus” of workers from the profession and to other healthcare settings, the American Health Care Association cautioned Friday. 

“The administration’s mandate can dramatically advance our joint goal of getting all staff vaccinated if thoughtfully implemented,” Mark Parkinson, AHCA president and CEO, wrote in a letter Friday. It was addressed to Health and Human Services Secretary Xavier Becerra and Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure.

Image of Mark Parkinson, president and CEO, AHCA/NCAL
Mark Parkinson, president and CEO, AHCA/NCAL

He cautioned that if implementation is not done in an “effective” way, there could be a “disastrous outcome for long-term care residents.”

Vaccine hesitancy among industry workers is “real,” and failing to recognize and address that will cause “hundreds of thousands of employees to abandon facilities and leave residents with limited or, in some cases, no care,” he warned.

Federal health leaders should undertake several key steps for an effective rollout, Parkinson wrote. Among them: 

  • Expand President Biden’s mandate order to include all healthcare workers in all Medicare- and Medicaid-certified settings 
  • Set aside $3 billion from the federal Provider Relief Fund to cover the cost of implementing the mandate
  • Implement a federally-funded daily testing alternative for staff who won’t take the vaccine
  • Expand worker education about the vaccination process
  • Modify CMS visitation guidance to allow providers to ask visitors about their vaccination and test results

Parkinson noted that prior to its joint vaccination campaign with LeadingAge, just 37% of nursing home workers agreed to the initial dose. That has now grown to 62%. While some may never be persuaded, there some can be, he added.

If a significant portion of the approximately 38 percent of unvaccinated nursing home staff leave, the net impact will be worse care for the residents.  

“While the loss of just half of the unvaccinated staff would be devastating to care, the loss of even one or two staff in a nursing home impacts care on certain shifts and units,” he wrote. “The plan to implement this requirement must focus on retaining current staff.”

“We would appreciate the ability to meet with both the secretary and the administrator to talk about this important policy,” Parkinson continued. “We want this to work and believe we can be of significant assistance in making that happen.”