Updated Sept. 10 at 8:22 a.m. Central, to reflect further industry reactions.

WASHINGTON, D.C. (September 9, 2021)—The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities—including home health agencies and possibly home medical equipment providers—to protect both them and patients from the virus and its more contagious delta variant. Homecare providers across the country should make efforts now to get health care staff vaccinated to make sure they are in compliance when the rule takes effect, the government said in its announcement. 

The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), announced today that emergency regulations requiring vaccinations for nursing home workers will be expanded to include hospitals, dialysis facilities, ambulatory surgical settings, home health agencies and home medical equipment providers, among others, as a condition for participating in the Medicare and Medicaid programs. Durable medical equipment providers were listed in the full list of included facilities here but not mentioned specifically in the release. The decision was based on the continued and growing spread of the virus in health care settings, especially in parts of the U.S. with higher incidence of COVID-19. 

“There is no higher priority for us than patient health and safety. As the delta variant strengthens, the Biden-Harris Administration is committed to doing everything we can to keep patients, and those who care for them, safe,” said U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra. “There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health. Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential.”

Nursing homes with an overall staff vaccination rate of 75% or lower experience higher rates of preventable COVID-19 infection. In CMS’s review of available data, the agency is seeing lower staff vaccination rates among hospital and End Stage Renal Disease (ESRD) facilities. To combat this issue, CMS is using its authority to establish vaccine requirements for all providers and suppliers that participate in the Medicare and Medicaid programs. Vaccinations have proven to reduce the risk of severe illness and death from COVID-19 and are effective against the delta variant. CMS will continue to work closely with all Medicare and Medicaid certified facilities to ensure these new requirements are met.

“We know that those working in health care want to do what is best for their patients in order to keep them safe,” said CMS Administrator Chiquita Brooks-LaSure. “As the delta variant continues to spread, we know the best defense against it lies with the COVID-19 vaccine. Data show that the higher the level of vaccination rates among providers and staff, the lower the infection rate is among patients who are dependent upon them for care. Now is the time to act. I’m urging everyone, but especially those fighting this virus on the front lines, to get vaccinated and protect themselves, their families, and their patients from COVID-19.”

CMS is developing an Interim Final Rule with comment period that will be issued in October. CMS expects certified Medicare and Medicaid facilities to act in the best interest of patients and staff by complying with new COVID-19 vaccination requirements. Health care workers employed in these facilities who are not currently vaccinated are urged to begin the process immediately. Facilities are urged to use all available resources to support employee vaccinations, including employee education and clinics, as they work to meet new federal requirements.

Industry Reactions

National Association for Home Care & Hospice President Bill Dombi said in statement, “NAHC has encouraged vaccinations throughout the pandemic. We look forward to seeing the details of the President’s Executive Order.” 

Mark Parkinson, president and CEO of the American Health Care Association/National Center for Assisted Living, said, “We applaud President Biden for expanding COVID-19 vaccination requirements to all Medicare and Medicaid-certified health care settings as well as larger businesses. This will help prevent unvaccinated nursing home staff from looking for new lines of work, alleviating some of the staffing challenges too many long-term care facilities are currently facing. Nearly 4,000 providers expressed their concerns about a federal mandate only for nursing home staff, and we appreciate the Administration listening to those concerns and applying this policy more broadly.
“This vaccine policy will also help protect our nation’s most vulnerable, who often interact with a variety of health care professionals on a regular basis. We support the administration’s efforts to get more people vaccinated, and we look forward to working with them on finding additional solutions that will help us address this unprecedented situation," Parkinson concluded.

Katie Smith Sloan, president and CEO of LeadingAge, said,“Ensuring that all frontline health care staff are vaccinated just makes sense. This action not only shores up protection for older adults who move across care settings, but also levels the playing field among providers competing for in-demand health care workers.”

“The breadth of President Biden’s COVID-19 action plan will protect older adults and save many, many lives. This is the right next step to get COVID-19 under control," Sloan concluded.

AdvaMed president and CEO Scott Whitaker said, “We applaud the President and his administration for recognizing the critical roles regular testing and widespread vaccination serve in bringing the pandemic under control. We look forward to continuing to work closely with the administration to further extend the reach of quality testing, strengthening our public-private collaboration and coordination. Our diagnostic companies, as they have been from the beginning of this crisis, are fully committed to supporting our nation’s Covid response. Our industry has been leading the way, to ensure our employees and contractors are either vaccinated or regularly tested. It’s critically important to keep facilities open and ensure they remain as safe as possible so that the important work of manufacturing the medical technologies patients rely on can continue.”