An Estimated 91 Percent of Nursing Home Staff Nationwide Received the Required COVID-19 Vaccine Doses, and an Estimated 56 Percent of Staff Nationwide Received a Booster Dose

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Why OIG Did This Audit

The COVID-19 pandemic has hit nursing homes particularly hard. To reduce the spread of COVID-19 in nursing homes, the Centers for Medicare & Medicaid Services amended the infection control requirements for nursing homes to include a requirement for nursing homes to ensure that staff received all of the required COVID-19 vaccine doses (i.e., a single-dose vaccine or all required doses of a multidose vaccine) except for individuals granted an exemption from receiving the vaccine or individuals whose vaccination had to be delayed.

Our objective was to identify the COVID 19 vaccination status of nursing home staff as of the week ended March 27, 2022.

How OIG Did This Audit

We used a stratified multistage design to select a sample of nursing home staff nationwide. We stratified the sampling frame of 15,224 nursing homes nationwide into 10 strata based on the nursing homes' locations and randomly selected 10 nursing homes from each stratum. From each of the 100 sampled nursing homes, we obtained a list of staff members who were subject to the vaccination requirements and randomly selected 10 staff members. For each of the 1,000 sampled staff members, we reviewed documentation that nursing homes provided to determine whether the staff member had received the required vaccine doses, had received a booster dose, or had requested or had been granted an exemption from receiving the vaccine.

What OIG Found

As of the week ended March 27, 2022, we determined for the 1,000 nursing home staff members in our sample that 884 had received the required vaccine doses (506 of these staff members had also received a booster dose); 78 had been granted an exemption from receiving the vaccine based on a sincerely held religious belief, practice, or observance (religious exemption); 12 were partially vaccinated; 3 had been granted an exemption from receiving the vaccine based on a medical condition (medical exemption); and 3 had applied for an exemption that was being reviewed by a nursing home. For the remaining 20 staff members in our sample, the nursing homes did not provide us with documentation related to the staff members' vaccination status, or the documentation provided did not clearly identify the staff members' vaccination status. As a result, we were not able to determine the vaccination status of these staff members.

On the basis of our sample results, we estimated that 91 percent of staff nationwide had received the required vaccine doses, 56 percent of staff nationwide had received a booster dose, and 6 percent of staff nationwide had been granted a religious exemption. We did not estimate the percentages among the small number of staff members (i.e., 38) in our nationwide sample results who were partially vaccinated, who were granted a medical exemption, who applied for an exemption that was being reviewed, or for whom the vaccination status could not be determined.

In addition, the estimated percentages of staff who received the required vaccine doses, staff who received a booster dose, and staff who were granted a religious exemption varied depending on the locations (i.e., Department of Health and Human Services regions) of the nursing homes in which they worked.

What OIG Recommends

This report includes no recommendations. The results of this audit present a snapshot of the COVID-19 vaccination status of nursing home staff nationwide at a specific point in time.