Issues surrounding the COVID-19 public health crisis, vaccines and mandates were the top news stories of 2021 for nursing home operators and other long-term care providers. But those weren’t the only matters that kept readers’ attention this year. 

Here’s a rundown of the top stories that McKnight’s Long-Term Care News readers opened over the past 12 months. 

Vaccine mandate for nursing home, all healthcare workers

President Joe Biden in mid-August announced that nursing homes participating in the Medicare and Medicaid programs will be required to have all staff vaccinated against COVID-19 in order to continue receiving federal funding.

The regulation was later expanded to all healthcare workers after pressure from the long-term care industry. The policy impacts more than 50,000 providers and over 17 million healthcare workers in certified facilities. 

The Centers for Medicare & Medicaid Services in early November released the rule for the mandate, which required all workers to be fully vaccinated against COVID-19 by Jan. 4. The rule does allow for exemptions for medical conditions or religious beliefs, observances or practices. 

How will the US define who’s ‘fully vaccinated’ in the future

Nursing homes and other providers in late November questioned whether the definition of “fully vaccinated” might change for healthcare workers amid a rise of breakthrough cases, the emergence of the omicron variant and booster shots being approved for all American adults.

Top U.S. infectious disease official Dr. Anthony Fauci hinted at the time that an additional dose of a COVID-19 vaccine could eventually become the country’s standard.

CMS suspends enforcement of vaccine rule after court challenges

CMS in an early December memo to surveyors announced that it would not be enforcing its healthcare worker vaccine rule while preliminary injunctions blocked the regulation across the country. 

The move came days after federal judges in Missouri and Louisiana granted the temporary injunctions, first in 10 states, and then nationwide. As of production deadline, the mandate remained blocked in about half of the United States after a federal appeals court ruled that the Louisiana court only had the authority to block the mandate in the 14 states that sued in that specific case. (See latest developments here.)

CMS unveils more oversight of nursing homes, expanded visitation policy 

Nursing homes were directed to allow visitors “at all times” in expanded visitation guidance issued by CMS in mid-November. Providers were also told they are not allowed to restrict access to surveyors based on vaccination status, nor ask a surveyor for proof of vaccination status as a condition of entry — a policy that was immediately questioned by industry leaders and is expected to be updated by CMS soon. 

The updated visitation guidance was paired with a second memo that gave state surveyors steps on how to address a backlog of complaint and recertification surveys and resume regular work. 

Vaccination rule for large companies doesn’t require employers to pay for testing 

An early November report revealed that the highly-anticipated federal COVID-19 vaccination rule for large companies with 100 or more workers would be allowed to make unvaccinated employees pay for weekly tests and personal protective equipment, unless they were subject to a collective bargaining agreement. 

The rule, which was issued Nov. 4, was suspended following several court orders in cases challenging the regulation. The Biden administration has moved to get the rule reinstated. 

CDC lifts nursing home restrictions on dining, group activities

The Centers for Disease Control and Prevention in late April released guidance that allowed fully vaccinated nursing home residents to resume dining activities without masking or social distancing restrictions. It also permitted visitation and personal contact among residents and visitors who were fully vaccinated.

A movement to cap nurse-agency pay rates advances

Pennsylvania lawmakers considered introducing legislation that would regulate temporary staffing agencies, set maximum pay rates for agency healthcare personnel and require contract healthcare service agencies providing temporary work in nursing homes to register with the state as a condition of operation. In addition, national provider organizations have asked the Federal Trade Commission to intervene in staffing issues, citing anticompetitive practices.

More stories that kept readers captivated this year included: Genesis HealthCare announced its COVID-19 vaccination mandate for all employees, care partners and onsite vendors; an October study found that “recovered” COVID patients with a sore throat and nasal symptoms may still test positive; and physicians warned of delayed skin reactions to the COVID-19 vaccine.