An Emergency Rule published November 12, 2021, by Missouri’s Department of Health and Senior Services allows skilled nursing facilities and intermediate care facilities of Missouri to close for up to two years if they are short staffed because of the vaccine mandate. The facilities could reopen up to two years later without having to start the licensure process from the beginning.
The Centers for Medicare & Medicaid Services (CMS) is requiring all staff who are employed in facilities receiving federal funding from CMS to be vaccinated against the COVID-19 virus. The staff members must receive an initial dose by December 6, 2021, and complete their vaccination series by January 4, 2022, unless the staff member is granted a religious or medical exemption.
The most recent data by CMS shows that Missouri has an average of 56.7% of its healthcare staff in nursing homes fully vaccinated. Missouri is listed last nationally in vaccination rates for healthcare staff. Missouri’s State Attorney General Eric Schmitt is part of a 10 state coalition seeking to block the vaccine mandate.
The Missouri Department of Health spokesperson stated that the closure rule is “out of an abundance of caution,” since they do not know whether it will be necessary. Additionally the spokesperson stated, “Facilities may have no other option than to close temporarily if workers are not vaccinated, or if they are unable to hire vaccinated employees to ensure resident health and safety.”
The executive director of the Missouri Health Care Association stated, “ The vaccine hesitancy in all areas of the state is very high, and especially in rural areas is very high. The emergency closure rule would provide facilities with a last ditch effort to be able to reopen in the future if the workforce situation changes. Our facilities have done everything to try to convince people to take the vaccine, but the state is going to have to react to facilities shutting down.”
Issue:
All facilities must be aware of their vaccination rates among staff. Employees should be made aware of the recent federal vaccination mandate, with additional education about the vaccine provided to staff members who are not vaccinated against COVID-19. Leaders of facilities must have an emergency plan ready to implement should staffing levels decrease significantly due to the vaccine mandate.
Discussion Points:
- Review your Infection Control Plan and your policy and procedure on the COVID-19 vaccination. Ensure that both include the most up-to-date information from the CDC. Develop a process for ensuring that all required education and vaccination data is accurately recorded and is reported timely per CMS requirements.
- Train all staff on your Infection Control Plan and COVID-19 policies for vaccination and prevention of the spread of the virus. Provide additional education to the unvaccinated prior to reoffering the COVID-19 vaccine. Train appropriate staff on the need to record and report vaccination status for residents and staff alike per CMS guidelines. Place training documentation in each employee’s education file.
- Periodically audit to ensure that all staff are following your Infection Control Plan, and that staff are aware of the benefits and risks associated with the COVID-19 vaccination. Audit vaccine education records, consent completion, and administration rates and provide additional education where needed. Monitor to ensure that vaccination reporting occurs each week as required.
