Implementation of COVID-19 Vaccination Condition of Employment in a Community NH

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

This case study published in JAMDA[1]examines the policies and processes of a 180-bed skilled nursing home in an urban area owned and operated by a not-for-profit, non-chain affiliated organization. The nursing home employs 246 staff who were included in the analysis of vaccination rates. In partnership with operational leaders in both administration and patient care, COVID-19 documentation of vaccination uptake activities were reviewed. Documentation included internal email communications, vaccination education handouts, and facility vaccination completion rates. A timeline and classification of events were constructed. Additionally, interviews were conducted with key personnel to reflect on the process of decision making and implementation of COVID-19 vaccination strategies. This process evaluation included the executive leadership team, human resources leadership, medical team, nursing home staff, and members. Nursing home vaccination rates over time are provided starting with the first vaccination clinic on January 5th, 2021 and ending with the go-live date for the COVID-19 vaccination COE policy on May 1, 2021.


The addition of the COVID-19 vaccination COE resulted in the nursing home achieving 100% compliance with the COVID-19 vaccine COE by May 1st, 2021. Among staff present at the initiation of the COVID-19 vaccination process, the nursing home achieved a COVID-19 vaccination rate of 89.9% (n=246). Among staff who initiated COVID-19 vaccination with a first dose (n=221), 98.6% went on to complete the vaccination sequence. Three employees were exempt from the COVID-19 vaccination due to religious or medical exemptions; an additional four employees remain on a leave of absence. A total of 17 employees (6.9%) resigned from 170 their positions at the nursing home. Vaccination rates over time are summarized in Figure 2.”

This case study/article was published in the August edition of the Journal of Post-Acute and Long-Term Care Medicine.

This article is an interesting read and well worth your time.  Implementing vaccination as a condition of employment does work, when planned and done thoughtfully.  Working to achieve 100% vaccination of staff in your facility can be achieved – and it will save lives.

[1] © 2021 Published by Elsevier Inc. on behalf of AMDA — The Society for Post-Acute and Long-Term Care Medicine.