A major chain of senior living facilities will require more than 10,000 workers to get COVID-19 shots

  • Atria Senior Living, a large operator of independent living, assisted living, and other senior living facilities, is requiring more than 10,000 US employees to get the COVID-19 vaccine.
  • Atria CEO John Moore told Business Insider that requiring the vaccine is "the responsible thing to do" to stop the spread of the coronavirus among staff and residents.
  • Several other long-term care companies told Business Insider they are not mandating the coronavirus vaccine.
  • Employers can require staff to give COVID-19 shots without running afoul of the law, according to federal guidance, and more employers are expected to follow in Atria's footsteps.
  • Visit Business Insider's homepage for more stories.

A major operator of long-term care facilities said it will require COVID-19 shots for its US employees, becoming one of the first big companies to impose a vaccine requirement for its workers.

Atria Senior Living, which has more than 10,000 US workers and operates senior living communities in 26 states and Canada, said Monday that all US employees will be required to take both doses of the vaccine by May 1.

Atria CEO John Moore said the company decided to make COVID-19 shots mandatory because "it's the responsible thing to do" to stop the spread of the coronavirus among staff and residents, especially since long-term care facilities like Atria have received priority access to the vaccines.

Atria wanted to nudge employees to take advantage of this priority access before CVS Health began the second of the three clinics it will hold at each facility, he said. CVS held a second clinic at one Atria facility on Monday, and Moore was among employees that received his second shot.

"We're seeing more COVID activity and larger outbreaks in communities among residents and staff. In this world where you get priority access to the vaccine, it just feels like the responsible thing for us to do to stop the disease where we can, if we have the tools to do it," Moore said in an interview.

Atria will also require new hires who start after CVS completes its on-site clinics to get a shot elsewhere, he said.

Atria appears to be one of the first long-term care companies to require staff to get a COVID-19 shot

Several other long-term care chains that Business Insider contacted, including Brookdale Senior Living, Genesis Healthcare, ProMedica Senior Care, and Signature Healthcare, said they are not mandating COVID-19 vaccines for staff, though they are encouraging staff to get the shots.

According to the American Hospital Association, most hospitals are waiting until the vaccines receive full approval from the US Food and Drug Administration before they decide whether to mandate the vaccine for workers.

Read more: Healthcare workers and long-term-care facility residents should get a coronavirus vaccine first, according to US health officials

"What we're hearing from our members is that they will likely make determination of requirement of the COVID-19 vaccine based on safety and efficacy data available at the time the vaccines receive full approval, which likely won't happen until the spring at the earliest," said Michelle Hood, AHA executive vice president and chief operating officer.

Two COVID-19 vaccines from drug companies Pfizer and Moderna have received emergency-use authorization from the FDA.

So far, nearly 9 million people in the US have received the first dose of the two-dose vaccines. In most states, healthcare workers, along with staff and residents at long-term care facilities, were prioritized to receive the first shots.

The vaccine rollout at long-term care facilities has been slow, with less than 1 million shots administered

The vaccine rollout has lagged at long-term care facilities, whose residents are among those at highest risk for COVID-19. Most states opted into a federal program in which pharmacy chains CVS Health and Walgreens are handling COVID-19 vaccinations in long-term care settings, including nursing homes and assisted living communities.

But while more than 4.2 million doses have been distributed for use in long-term care facilities, just 937,028 shots have been given in those settings, according to the latest CDC data.

Some nursing homes are having trouble getting staff to roll up their sleeves for a shot.

Dr. Richard Feifer, the chief medical officer at nursing home company Genesis, told Business Insider last week that staff vaccination rates vary widely across its facilities. In some cases, fewer than half of its workers have agreed to get the vaccine, while other facilities have seen staff acceptance rates of higher than 75%, he said.

"Anything less than 75% is unacceptable and you need to improve it," Feifer said. He added that Genesis is working hard to improve staff vaccination rates by engaging hesitant staff members directly and launching a social media campaign.

At Atria, Moore said uptake of the vaccine among staff has been "good," but he said workers weren't given much notice ahead of the first clinics, so some wanted to wait to get the vaccine. So far, about 2,000 Atria employees and residents have received the first dose of the COVID-19 vaccine. Vaccination clinics are scheduled in about two-thirds of Atria's 170 US communities, with more clinics being added daily.

When asked how employees reacted to the vaccine being mandated, Moore said initial conversations were "overwhelmingly positive."

Atria already requires that its workers get a tuberculosis test. The company defers to state requirements on whether employees must get a seasonal flu shot.

Healthcare facilities have increasingly required employees to get flu shots. In 2017, about 61% of hospitals required healthcare staff to get an annual flu shot, up from 37% in 2013, according to a study published in the Journal of the American Medical Association in 2018.

Read more: 3 major primary-care chains share how they're preparing to vaccinate thousands of vulnerable patients

Federal guidance paved the way for employers to mandate COVID-19 vaccines. 

Legally, employers can require workers to get COVID-19 vaccines, and more are likely to do so as the shots become more widely available, said Renee Mattei Myers, an attorney in the employment labor group at law firm Eckert Seamans.

The US Equal Employment Opportunity Commission, a federal agency in charge of enforcing workplace anti-discrimination laws, issued guidance in December that paved the way for employers to mandate COVID-19 vaccines, she said.

The Americans with Disabilities Act restricts when an employer can require a medical examination. The EEOC guidance confirmed that the COVID-19 vaccine would not be considered a medical examination under the law, removing a restriction that could have prevented employers from requiring the vaccine, Myers explained.

Still, there are exceptions to the rule. Employers may need to make an accommodation for employees that are unable to take the vaccine for medical or religious reasons. Failing to make that accommodation could land an employer in legal hot water.

"Giving a blanket mandate, without doing an individualized assessment—for example, saying all employees that refuse to get the vaccination are going to be immediately terminated — that would cause an issue," Myers said.

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