COVID-19 Vaccination Rates Among Nursing Home Staff Have Risen by 25 Percentage Points Since the Biden Administration Announced a Vaccination Mandate for Health Care Workers Last Year

Vaccine Mandate Does Not Appear to Have Exacerbated Staffing Shortages, Analysts Find

In a new analysis, KFF researchers find that COVID-19 vaccination rates among nursing home staff increased by 25 percentage points nationally (63% to 88%) from when the Biden administration announced the vaccine mandate for health care workers in August 2021 to after vaccination deadlines passed in March 2022.

Researchers analyzed nursing home-level data from the federal government covering some 14,700 nursing homes, or about 97 percent of all nursing homes in the U.S. They conclude that while a number of factors may have been at work, it appears that the mandate contributed to the increases in staff vaccination rates.

As of March 2022, 12 percent of nursing homes nationally reported that 100 percent of their staff were fully vaccinated, while 39 percent reported staff vaccination rates of over 90 percent but less than 100 percent. The remaining 49 percent of nursing homes reported that fewer than 90 percent of their staff had been fully vaccinated.

While the federal mandate does not explicitly require booster shots, the national booster rate for nursing home staff was 44 percent as of March 2022.

Some nursing home operators warned that requiring health care workers to be vaccinated against COVID-19 could contribute to staffing shortages. Data suggest that the vaccine mandate has not exacerbated such shortages, however.

KFF analysts find that 28 percent of nursing homes in the U.S. reported staffing shortages as of March 2022, down slightly from the peak in January 2022 where nearly one in every three nursing homes reported a shortage.

Staff shortages in nursing homes are a longstanding problem that predates the pandemic. In a separate analysis also released today, KFF analysts summarize federal and state standards related to nursing home staffing prior to COVID-19 and identify changes that states have made to minimum staffing requirements during the pandemic. They also examine state legislative and regulatory actions since the onset of the pandemic that directly affect worker wages and training requirements.

The Biden administration has announced plans to propose new federal minimum staffing adequacy regulations in the next year, and the National Academies of Science, Engineering, and Medicine recently recommended minimum staffing levels as part of its comprehensive report on ways to improve nursing home quality.

Conditions and COVID-19 precautions in nursing homes remain a subject of heightened public interest since over one in five COVID-19 deaths during the pandemic has been in a long-term care facility. While the vaccine mandate remains in effect, litigation challenging the new rule is ongoing. Although cases in Texas and Florida were dismissed after the Supreme Court allowed the rule to take effect, cases in Missouri and Louisiana are still pending.

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Chris Lee | (202) 654-1403 | ChrisL@kff.org

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