How Will the Federal Vaccine Mandate Affect Your Post-Acute or Long-Term Care Facility?

As many of you are aware by now, the Biden Administration expanded vaccination requirements to cover all Medicare and Medicaid-certified facilities as of September 9, 2021. This announcement is different from the original mandate, which only required nursing home facilities to have their staff fully vaccinated with no mention of other health care settings such as home health agencies or hospitals having similar requirements.

With the expansion of the vaccine mandate, there will be certain business implications that will affect your facility. 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.

While many of the implications of the mandate are positive, there might also be some talent acquisition and retention challenges that arise due to vaccine hesitancy. Here’s a closer look: 

What should you do if your employees are still refusing the vaccine?

Let’s address the elephant in the room. The decision has been made for you and any acute, post-acute, or long-term care facilities that participate in Medicare or Medicaid programs will require all workers to be vaccinated. So the question now becomes, will you lose employees because of the mandate? Answer: probably. However, there is no telling how many people are willing to walk away from an industry doing what they love or have been trained to do. Generally speaking, most people get into a career in healthcare because they genuinely like helping people.

As you review your roster, you are looking at a list of individuals that have, for the most part, worked through dangerous, demanding, and high stress conditions for nearly two years. If they didn’t leave you then, they’re probably loyal to the healthcare space. According to a recent survey conducted by Hireology, 66% of healthcare workers have a positive perception of the healthcare industry despite all of the challenges currently faced by employees today.  Looking back on all of the countless stories about healthcare workers showing up day in and day out despite so much uncertainty and insurmountable odds just to continue to help those in need speaks volumes about our healthcare community.

But you will still have hesitant employees, and it’s important that you treat them with compassion and empathy. You should not berate, belittle, bad mouth, or threaten your employees with ultimatums. Put yourself in their shoes to understand what their hesitations are and where they are coming from.

Remember, most of the uncertainty is due to the spread of misinformation, which has made a full scale vaccine rollout challenging. Questions about safety, efficacy, and side effects have dominated the news cycles, and sowed seeds of doubts among many Americans.

So it’s important to lead by example and provide your employees with plenty of information so that they can make an informed decision. 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 and share them with your team. The goal is to help them make the most informed decision possible, and hopefully, get them to stay in the healthcare industry.       

Retaining existing employees and attracting new employees with the vaccine mandate

Once again, vaccines have been mandated for all healthcare facilities so there isn’t really a way around that. Those individuals that feel strongly about not getting the vaccine will not be looking for positions in the healthcare industry and generally will not be worth your time and effort. For all the rest, here are some tips to help you stand out.

Retaining Employees

Start off by educating staff about the vaccine mandate and the vaccines themselves to ensure that there are no misconceptions about what they should expect moving forward. You will, without a doubt, lose some employees as a result of the mandate, but as long as you have been open and honest, and provide all the appropriate information, know that you did what you could. You will not be able to convince those who have already made up their mind and you need to let them go. Instead, focus on employees that are on the fence because those are likely the ones that just need some counseling.

Another option to retain talent is pay them to get vaccinated. Organizations, such the National Minority Health Association, have partnered with home care and home health agencies to provide financial incentives to workers for getting vaccinated through their Flex for Checks program. In essence, you are encouraging your staff to get vaccinated and offering compensation in the form of a retention bonus for complying with federal regulations.

On average, the cost of turnover associated with replacing a caregiver is around $2,600 per employee, however, this figure only increases when you account for more higher skilled positions across your organization. One article by SAGE Open Nursing estimated that the range for registered nursing turnover was anywhere between $10,000 and $88,000 with an average around $36,000. With that in mind, it would make fiscal sense to offer compensation to get vaccinated if you are worried about employee turnover.

Attracting new employees

When it comes to recruiting, be open and honest with applicants and candidates about the new policies surrounding the vaccine mandate and don’t leave any room for interpretation or misunderstanding. You want to be clear and transparent about what your expectations are from the start. The last thing you want to do is go through the painstaking effort of bringing on a new employee only to have them attrit a couple weeks in. It’s better to have an applicant self-select themselves out of the process early on rather than get through the entire hiring process and have them leave.

We have also seen companies offer both a sign-on bonus and a retention bonus for new employees. The sign-on bonus is very common, but the retention bonus is designed to entice employees to stay longer and not be lured away to other opportunities. As mentioned in the section above, both of these bonus offerings still pail in comparison to the costs associated with losing an employee to turnover, so if you can bake in benefits that are designed to keep employees around longer then your organization will benefit tremendously in the long-run.     

Enticing patients to return to the facility-based care setting

First and foremost, remember that patients and their families are still operating with an abundance of caution as it relates to potential exposures to the coronavirus. For many, 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 remote work 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. 



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