Photo: Adam Schultz/Biden for President. Creative Commons license 2.0

As part of his "Come on, man!" campaign to get Americans vaccinated against the coronavirus, President Joe Biden yesterday announced that if nursing homes want to keep getting Medicare and Medicaid money, they damn well better require their staff be vaccinated, because come on, man, the vaccines have been available for months, for crying out loud. (Clarification: Biden is using every tool possible to encourage vaccinations, but there is no formal "Come on, man!" campaign. That's just malarkey we made up.)

Biden framed it as just plain common sense: "If you visit, live or work in a nursing home, you should not be at a high risk for contracting COVID from unvaccinated employees." Damn right, Joe.


The requirement will be formalized in a new rule to be issued soon by the Centers for Medicare & Medicaid Services (CMS), and could go into effect as soon as September, because come on, man, lives are at stake, and even though deaths in long-term care facilities account for about a third of the US death toll, there are, incredibly, still a lot of unvaccinated people working in nursing homes.

Hundreds of thousands of nursing home workers are not vaccinated, according to federal data, despite those facilities bearing the brunt of the early COVID-19 outbreak and their workers being among the first in the country to be eligible for shots.

We can do a lot better than that, man.

Biden added that he's well aware a president's ability to require public health measures is limited, but "I'm going to continue to look for ways to keep people safe and increase vaccination rates."

Biden has already required that federal workers either get vaccinated or agree to regular testing for the virus, and to wear personal protective equipment as needed in the workplace, and has his administration looking for any conceivable way to use the machinery of the executive branch to get people protected from the pandemic. It's a little like how Stephen Miller sought to weaponize every aspect of federal power to the task of stopping immigration, only dedicated to saving lives, not ruining them.

In addition, Biden said he will also direct Education Secretary Miguel Cardona to employ

"all of his oversight authorities and legal action, if appropriate, against governors who are trying to block and intimidate local school officials and educators" who want children to wear masks in the classroom.

The President indicated that American Rescue Plan funds can be used to pay educators who have their paycheck cut by local and state governments if their schools implement mask mandates.

Good!

Fortunately, vaccination rates among nursing home residents are well above the national average, with 84 percent of residents in long-term care facilities being fully vaccinated (that rate does vary by state, from a low of 68 percent of residents in Nevada facilities to an impressive 93 percent in both Vermont and, oddly, South Dakota). And because vaccine booster shots will be going to people eight months out from their second injection of the Pfizer and Moderna vaccines, nursing home residents will automatically be among the first to get the boosters, since they were prioritized when the vaccines first became available.

But as CNN notes, the vaccine rates for nursing home staff aren't all that different from the rate in the general public:

About 1.3 million people are employed by the more than 15,000 nursing homes that participate in Medicare and Medicaid. Some 62% of those workers are vaccinated nationwide, according to CMS data, but the figure ranges from 44% to 88% depending on the state.

"We have seen tremendous progress with low Covid rates within the nursing home population and I think we're seeing signs that it is starting to tip the other direction. We don't want to go backwards," said Jonathan Blum, CMS' principal deputy administrator.

Blum said CMS officials are "confident we have the legal authority" to implement the new regulation, noting that the law allows CMS to take action as it relates to the health and safety of nursing home residents.

Some representatives of the nursing home industry fret that mandatory vaccinations could worsen healthcare staffing shortages, since some portion of the workforce might decide they'd rather not take a safe, effective step to protect the people they're supposed to be taking care of.

"Focusing only on nursing homes will cause vaccine-hesitant workers to flee to other health care providers and leave many centers without adequate staff to care for residents. It will make an already difficult workforce shortage even worse," said Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living, which represents 14,000 facilities. "The net effect of this action will be the opposite of its intent and will affect the ability to provide quality care to our residents."

And it's certainly true that the hospital industry has seen instances of nursing and other staff refusing to get vaccinated, which is just bizarre to see among people who you'd assume know about healthcare. If nursing homes do see people leaving their jobs because they won't get vaccinated, that could be a problem, especially since many staff left last year because there was so much danger of becoming infected.

We'd like to think that knowing they'll be working in a far safer environment might attract some of those folks back to nursing home jobs — and perhaps nursing homes could pay them something more than starvation wages, too, particularly if HHS releases stimulus funds in the Provider Relief Fund that was part of last year's stimmy packages.

We'll close on an interesting bit of history not-trivial-at-all, from Larry Levitt, senior vice president at the Kaiser Family Foundation, who reminds us that Biden's action isn't all that unprecedented:

We bet some healthcare providers also squawked at that previous federal mandate, too. Oddly, the industry survived.

[HuffPo / CNN / Photo: Adam Schultz/Biden for President. Creative Commons license 2.0]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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