The Missouri health department is giving nursing homes a legal pathway to temporarily shut down if they face staffing shortages because of a new mandate from President Joe Biden's administration for healthcare workers to be vaccinated against COVID-19.
An emergency rule published Friday from the state Department of Health and Senior Services would allow skilled nursing and intermediate care facilities to close for up to two years, if they are short staffed because of the vaccine requirement. They could then reopen without having to start the licensure process from scratch.
Missouri's nursing homes have some of the lowest COVID-19 vaccination rates nationally, and the state's top Republican elected officials have been pushing back against Biden's vaccine requirements. State Attorney General Eric Schmitt sued this week as part of a coalition of 10 states seeking to block the vaccine mandate.
The state health department drafted the closure rule "out of an abundance of caution," not knowing whether it will be necessary, said department spokeswoman Lisa Cox.
"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," Cox said.
Not a Modern Healthcare subscriber? Sign up today.
A federal rule issued last week by the Centers for Medicare & Medicaid Services requires COVID-19 vaccinations for more than 17 million workers in about 76,000 healthcare facilities and home healthcare providers that get federal funding from the two health programs for senior citizens, the disabled and low-income residents. Staff must receive an initial dose by Dec. 6 and complete their vaccination by Jan. 4, unless granted a religious or medical exemption.
When initially announcing the vaccine requirement for nursing home staff in August, the CMS administrator said higher vaccination rates among staff are linked to fewer outbreaks among residents.
The most recent CMS data ranked Missouri last nationally with an average of 56.7% of its healthcare personnel in nursing homes having completed their COVID-19 vaccinations as of Oct. 31.
Some nursing home administrators have expressed concerns that they may have to close because of the vaccine mandate, said Nikki Strong, executive director of the Missouri Health Care Association, which represents about 350 long-term care facilities.
"The vaccine hesitancy in all areas of the state — and especially rural areas — is very high," Strong said.
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, she said.
"Our facilities have done everything to try to convince people to take the vaccine," Strong said. But "the state is going to have to react to facilities shutting down."