NOTE: This article was written and posted by AAPACN on August 19, 2021. Proactive Medical Review has received permission to repost this article in full.


Yesterday, President Biden announced that nursing homes must vaccinate their staff or lose Medicare and Medicaid funding. The exact guidance and compliance requirements are expected in September. Although this mandate is an effort to help keep people safe from COVID-19, some providers report concern that staff will leave to go to other healthcare provider types that do not require vaccination. In several nursing homes, staff have previously threatened to quit, forcing nurse leaders to confront the possibility of staff shortages. Until there is clear guidance and a deadline for the new mandate, there are a few things nurse leaders can do to help address staff fears and concerns.

Keep calm

Staff are watching the response of the leadership team. Although this is a big announcement—and you may not agree or may fear staff will leave—getting upset or angry isn’t going to change the new rules. Chaos won’t improve the situation, and it could make things worse.

Hold a staff meeting

Get staff together as soon as possible to clearly communicate the new requirement. Be transparent that there is no current guidance on the new requirement, but more information is expected in September. Don’t allow gossip and speculation to become the way the news spreads. During this meeting, let staff know their concerns are being heard. Offer to set up times with individuals to discuss their specific concerns in private.

Plan one-on-one discussions

Unvaccinated staff may have personal reasons for not getting the vaccine. Set up meetings with these individuals and talk through their concerns in a private manner. Use the CDC COVID-19 Vaccination Communication Toolkit as a resource.

Don’t tolerate bullying

Vaccinated staff and unvaccinated staff may be at odds, and this may cause an even further rift. Additionally, some staff may be encouraging others to “walk out,” strike, or even quit and sue the provider. Don’t tolerate this; protect the staff that wish to comply.

Empower the champions

Speaking of staff who wish to comply, encourage them to be champions for the vaccine. By sharing why they are vaccinated—not in a forceful or mean way, but in a way that is sincere and caring—these staff members can help to model the behavior being promoted. For example, one staff member who had previously refused the vaccine changed her mind after watching a family member in the ICU with COVID-19. To encourage other staff to get vaccinated, she shared how her close-up experience with COVID-19 changed her perspective.

Address misinformation

There is a lot of misinformation about the vaccines going around. Address misinformation with facts. There are several resources available that can help address misinformation staff members may have seen. One place to begin is with this article: How to Talk to Someone Who is Misinformed about Coronavirus.

Plan ahead

Lastly, plan for the vaccine roll-out. Pull together a task force to identify and address barriers. Contact the pharmacy about obtaining vaccines, order extra supplies, and determine when, where, and who will provide vaccines. There is also a need to have a crisis plan to address potential staffing issues and how vacant shifts will be covered across all departments if employees do decide to leave.

For additional information and resources, please visit Please stay tuned for additional information from the Centers for Medicare & Medicaid Services on the specifics of this new mandate.

Read this article on the AAPACN website.