Some senior living operators are instituting mandatory COVID-19 vaccinations for employees, but others are weighing their options.

Frederick, MD-based Asbury Communities, for one, is not mandating vaccination — yet. During a Wednesday LeadingAge membership call, Asbury Communities General Counsel Andy Joseph said that once COVID-19 vaccines receive full Food and Drug Administration authorization, not just emergency use authorization, the company will mandate them.

The operator of eight life plan communities implemented a mandatory flu vaccine program three years ago. Employees may opt out for religious or health reasons. Joseph said when the COVID-19 vaccines started rolling out under EUA, the company offered the vaccine, providing the same opt-out options, but it added another option — the ability to opt out “just because” the vaccine is in EUA mode.

Once the COVID vaccine is fully authorized, however, he said, “We will handle it just like our regular flu program, where it will be mandated, and there will be two opportunities to seek exemption that must be approved through a committee.” Some states are considering legislation “that would cause a problem in doing that, potentially,” Joseph added, “so we have to keep an eye on that.”

Almost 100% of Asbury residents have opted into vaccination, but the employee uptake rate is closer to 50%.

No resident has requested to interact only with vaccinated staff, Joseph said, but Asbury anticipates such requests will occur in the future. The operator will not be able to manipulate staffing to handle that kind of request, he said, adding, but residents will be assured by staff wearing personal protective equipment and by the other protocols in place. Employees still undergo daily coronavirus screenings as well as testing protocols, Joseph said.

Mandates, incentives

The U.S. Equal Employment Opportunity Commission in December released guidance stating that employers can require proof of COVID-19 vaccination from employees, with some exceptions. Although federal laws can require employers to grant exemptions based on disability or religious accommodations, employers may be permitted to exclude from the workplace individuals unable to receive a COVID-19 vaccine under certain circumstances.

Among providers that already have mandated vaccination for employees are Atria Senior Living and Juniper Communities. 

Others are providing incentives, including paid leave to obtain the vaccine or for employees who experience any side effects after vaccination. Atlas Senior Living, for example, has a $1.1 million employee vaccination incentive program, offering workers up to four days off each if they are vaccinated. 

State laws may cause some headaches in this area, according to this JD Supra article. An Oregon law, for example, requires that certain healthcare employers must provide — but generally cannot mandate — vaccines to employees. In California, however, state law grants healthcare employers the power to mandate certain vaccinations.

Cory Kallheim, LeadingAge vice president of legal affairs and social accountability, said that about half of the states have mandatory vaccination programs for healthcare workers, including long-term care workers. But some states are introducing legislation prohibiting mandatory vaccination by employers and other entities, he added.