Missouri Sens. Roy Blunt and Josh Hawley, both Republicans, are demanding answers from the Department of Veterans Affairs on how veterans in long-term care facilities could be impacted by federal COVID-19 vaccine mandates.

The senators last week sent a letter to VA Secretary Denis McDonough asking whether state-run facilities that fail to comply would be forced to close or have residents removed. State-run VA facilities could be affected by both a Centers for Medicare & Medicaid Services’ rule governing healthcare workers and an executive order requiring federal government contractors to be fully vaccinated by Jan. 18.

“We are concerned that implementation of these federal vaccine mandates will cause Missouri’s long-term care facilities to lose their status as federal contractors with the VA and jeopardize the well-being of our veterans,” the senators wrote. “Additionally, we are concerned that federal vaccine mandates will create staffing shortages in long-term care facilities in Missouri, and that there will not be an open, compliant facility with sufficient staff capacity to accept veteran patients.”

In Missouri, 45 long-term care facilities contract with Veterans Affairs to provide services to VA beneficiaries. Missouri also has the lowest nursing home staff vaccination rate among all U.S. states, at 58.77%, according to data updated by the Centers for Medicare & Medicaid Services on Wednesday. That’s compared to a nationwide average of 74.3 % among all nursing homes.

The senators cite reports that federal Veterans Affairs officials have told state VA facilities that residents could be removed from facilities that don’t comply with federal vaccination mandates.

Among the requests Blunt and Hawley made to McDonough are for the department to provide an explanation of any contract-termination process in development; relay information on whether veterans could indeed be removed from their current care facilities or whether they could be forced to pay out of pocket if they refuse to move; and explain whether other long-term care facilities with better vaccination rates would be considered as alternative VA contractors.