At the time of this publication, the vaccine has not been mandated by the federal government, but that could become a requirement for any agencies that receive Medicare or Medicaid funding. 
It’s worth noting that an employer, or state or local government could create a mandate based upon specific societal needs for safety.  For the time being, however, there’s no explicit requirement mandating the vaccine at the highest levels of government.  
The creation of the COVID-19 vaccine brings with it a certain sense of hope and healing that our country and industry desperately need.  With the new eligibility rules announced on April 19, the entire US population over the age of 16 now are eligible to receive the vaccine, and over 25% of the nation is fully vaccinated. While there’s still some uncertainty and fear out there for some individuals surrounding the vaccine, this article is not meant to take a stance, but rather, to offer some insight into what the availability of this vaccine means for your facility.  We do, however, encourage you to do what you feel is right for yourself, your family, your employees, and your clients.  

What to do if you (or your employees) are getting the vaccine?

For starters, be grateful!  Many individuals in other countries have not been given the chance or access to the vaccine yet, so you are fortunate to have been afforded the opportunity.  As leaders in your organizations, I would also encourage you to be honest and open with your staff regarding your experience with the vaccine.  There’s a lot of uncertainty out there due to the spread of misinformation, which  makes a full scale rollout challenging.  Questions about safety, efficacy, and side effects have dominated the news cycles, but your choice to get the vaccine carries a lot of weight with your employees.  You are looked up to by your staff, so lead by example and provide your employees with plenty of information so that they can make an informed decision.  
Most importantly, be patient with those that don’t want to get the vaccine now or in the future.  It’s crucial that you don’t berate or look down on those that are not comfortable with the vaccine.  Instead, support their decision and offer to discuss their concerns to get an understanding of their perspective and reasoning for not moving forward.  As long as their decision does not endanger your patients or other employees, then you should be able to make reasonable accommodations for those staff members.  Continue to provide PPE to employees and adopt an empathetic mindset.  How you handle these types of situations will speak volumes to your employees and show that you are caring and understanding of their beliefs and convictions.      

What to do if you (or your employees) are not getting the vaccine?

If you decide not to get the vaccine, that’s okay too.  Ultimately it is your decision, but be careful to not dissuade others from getting the vaccine.  As a leader, your actions influence those around you and can have wide reaching impacts on your team.  If employees have decided to get the vaccine, celebrate that fact with them and see if there’s anything else you can do to accommodate their decision.  
I would encourage you to continue to gather additional information from trusted sources, like the Center for Disease Control and Prevention, that discuss the effectiveness and safety of the vaccine as well as potential adverse reactions with a COVID-19 vaccines.  The goal is to make the most informed decision possible.  With that in mind, make sure that you are still following the recommended protocols of wearing a mask and donning the appropriate PPE to keep yourself, your employees, and your patients safe.        

How will the vaccine affect your facility?

Regardless of whether or not you or your employees choose to get the vaccine, there will be certain business implications with the availability of the vaccine.  In most cases, the vaccine was made available to our most vulnerable populations (seniors and essential workers) in the first phase with future phases focusing on the rest of the population.  So as more people get vaccinated, the desire to return to a sense of normalcy can be felt across the country.  Hospitals are able to start ramping up elective surgeries, which means that when patients no longer require acute care, they will be looking to your facility for support.  Vaccinated individuals will be able to visit their loved ones in your facility, and patients will no longer  have to recover without the support of their families by their sides.   

Staffing Requests

With that in mind, be aware that your vaccinated patients and their families may request vaccinated individuals to conduct their care.  This may cause some disruptions to your business if you have a high percentage of employees forgoing the vaccination.  The opposite may be true as well.  Some of your employees may only feel safe providing care to individuals that have received the vaccine, so be prepared to make those concessions, or have difficult discussions with your employees.  
In both cases, we want to be empathetic and cognizant of what these requests mean for our patients and employees who each want to feel heard and safe.  A sure fire way to lose both patients and employees is to ignore this fact and to diminish these requests.  Keep in mind that your reputation is on the line and bad press can lead to a reduction in referrals to your facility.     

Census Impacts

Depending on where in the country you are located, the pandemic affected many facilities quite differently.  For some facilities, there was a major reduction in census levels due to fear and uncertainty surrounding COVID-19.  The idea being that sick people are going to facilities to get treatment and have a higher likelihood of getting exposed to the coronavirus in a hospital or skilled nursing facility.  Therefore, in April and May of 2020, there was a shift away from facility-based care to home-based care, which was perceived to be safer as detailed in the National Health Spending graph below.   

    Source: HealthAffairs blog
To date, census levels still remain much lower than in years past.  Now we have the introduction of the vaccine which could lead to a shift back from home-based care over to facility-based care.  While we don’t suspect that this will be an immediate shift, as more individuals get vaccinated and the public trust is restored in facility-based care organizations, patients will return to those locations once again.  

Entice patients to return to the facility-based care setting

First and foremost, patients and their families are still operating with an abundance of caution as it relates to potential exposures to the coronavirus.  The gamble is not worth the risk when lives are on the line, so you will have your work cut out for you.   
Start by building  your brand back up and providing patients with the confidence that they’ll be safe in your facility.  While you are likely taking many precautions to keep patients safe, go above and beyond to let them know exactly how you are taking the necessary measures.  
Outside of offering this information to patients, you will want to re-engage with your referral sources to share what changes you’ve made in this area.  Essentially, you want to convince your referral sources that you’re a desired place to be — and a great place to start is by highlighting all the changes that you’ve made to keep patients safe. Some of this may seem obvious, or even expected, but don’t assume that your referral sources have an intimate understanding of your internal business operations.  So take the opportunity to control the narrative, and become a destination of choice.  
If you haven’t already, focus on updating your technology offerings during this time.  The pandemic forced a lot of businesses to explore and adopt certain technologies, such as Zoom or other WHF options, to continue operations.  Are there technology offerings that you have been putting off investing in?  Focusing on softwares or technologies that will help you and your operation be more efficient will allow you to remain competitive in the industry and provide unique value propositions to your leadership team.       
Lastly, your people are your business and the care that they provide to clients is how you differentiate yourself.  Hiring the right people that align with your mission and values will make all the difference.  
 
The pandemic forced a change for many patients to vacate facility-based operations for home-based options, so this is your chance to make the necessary changes to attract those patients back into your facilities.  Give patients and their families a reason to return by offering and providing high quality care and a memorable experience.