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Medicare will start requiring nursing homes to report COVID vaccinations

Until now, nursing homes have been now required to report coronavirus cases and deaths — but not vaccinations. Only a few have provided the data voluntarily.

A senior receives the Johnson & Johnson COVID-19 vaccine at the Aaron E. Henry Community Health Service Center in Clarksdale, Miss. Medicare will require nursing homes to report COVID-19 vaccination rates for residents and staff in what officials hope will become an incentive to keep giving shots even as the worst ravages of the pandemic ease in facilities across the nation.
A senior receives the Johnson & Johnson COVID-19 vaccine at the Aaron E. Henry Community Health Service Center in Clarksdale, Miss. Medicare will require nursing homes to report COVID-19 vaccination rates for residents and staff in what officials hope will become an incentive to keep giving shots even as the worst ravages of the pandemic ease in facilities across the nation.
Rogelio V. Solis / AP

Medicare will now require nursing homes to report COVID-19 vaccination rates for residents and staff.

That’s as government officials hope to nudge the long-term care facilities to keep giving shots as the worst ravages of the coronavirus pandemic ease but the danger of a rebound still lurks.

“We’re hoping to drive increased vaccination rates among residents and staff, as well as transparency for residents and their families,” said Dr. Lee Fleisher, chief medical officer at the federal Centers for Medicare and Medicaid Services.

Medicare’s move to sustain the pace of vaccinations comes as an initial effort to get shots to nursing homes across the country has wound down. That partnership between the government and retail pharmacy giants Walgreens and CVS is being succeeded by an ongoing collaboration with specialized long-term care pharmacies that cater to the needs of the nursing home industry. Assisted-living facilities and other care centers serving older people also can participate.

A smooth transition will be critical because the coronavirus is far from eradicated even as new residents are being admitted to long-term care facilities and staffing ebbs and flows.

People living in long-term care facilities have borne a heavy toll from the pandemic. They represent about 1% of the U.S. population but accounted for roughly one in three deaths, according to previous estimates from the COVID Tracking Project.

“This is an important development that is months overdue,” said David Grabowski, a Harvard health policy professor who has tracked the industry’s struggles with the outbreak. “Many of us argued that this information should have been published starting in December, when the federal long-term care vaccination effort began.”

Nursing homes will now be required to submit weekly vaccination numbers for residents and staff to the federal Centers for Disease Control and Prevention. That requirement will take effect within two weeks. Medicare officials say it could take two to four more weeks afor the data to start coming in.

The plan is to post facility-level information on the Internet so residents and families can easily access the details from Medicare’s “Compare Care” website.

“This action will give us much greater insight into the levels of vaccination,” Fleisher said.

By being able to monitor across the entire industry, health officials will be able to direct vaccines to nursing homes that appear to be lagging.

For example, a new AP analysis of nursing homes in New York found that rates of vaccination have been far from even across the state. Overall, 79% of residents were fully vaccinated, as well as 55% of staff. In Brooklyn, though, the corresponding vaccination rates were 63% for residents and 40% for staff. New York facilities reported 782 infections among staff and residents in the 14 days ending April 25, the most in the nation.

Academic researchers think that the virus most likely entered nursing homes through staff members who had gotten infected elsewhere and became unwitting carriers. Many aides in the low-wage industry work shifts at different facilities.

Medicare’s new rule also requires nursing homes and facilities serving people with intellectual disabilities to offer shots and education about vaccination to residents, staff and clients.

Until now, nursing homes have been now required to report COVID cases and deaths — but not vaccinations. A relatively small number of facilities provide the data voluntarily to the government.

“Publicizing this information will hopefully encourage facilities and policymakers to continue efforts to vaccinate staff and residents,” Grabowski said. “Many staff were initially hesitant about the vaccine, and new staff and residents also need to be vaccinated. There is still a lot of work left to do.”

The numbers of cases and deaths have plummeted after the government launched a concerted effort to vaccinate residents and staff. According to the CDC, nearly 2.9 million nursing home residents and workers are fully vaccinated. Nursing homes and other long-term care facilities have again opened up family visits after spending a year in lockdown.

Nursing homes already are required to report rates of flu vaccination. But, until the new requirements were issued Tuesday, there was no similar requirement for COVID-19 vaccines even though the coronavirus is far more lethal.

The main nursing home industry trade group, the American Health Care Association, said it supports public reporting of vaccination data — but that it shouldn’t apply only to them. The lobbying group — whose leaders made clear their concern is that the vaccination data might be used to “judge” nursing homes with low rates of inoculation — wants hospitals, home health agencies and other providers to also be required to post their numbers.