NIC Notes

Insights in Seniors Housing & Care


By: Omar Zahraoui  |  July 14, 2021

Vaccination Rates Among Skilled Nursing Staff Continue to Lag Optimistic Expectations

COVID-19  |  Senior Housing  |  Skilled Nursing  |  Skilled Nursing Tracker

Vaccination rates among skilled nursing facilities’ workers continue to lag optimistic expectations. About 56% of all healthcare personnel have been fully vaccinated for the week ending June 27 vs. 79% of residents fully vaccinated, according to the most recent CMS data compiled by NIC’s Skilled Nursing COVID-19 Tracker. The reluctance among staff to get vaccinated is worrisome as the Delta variant becomes more dominant and COVID-19 cases rise among the general population across states with low vaccination coverage.

Now is the time to remember how devastating and tiring the battle against COVID was for skilled nursing facilities, particularly for frontline workers.

Exhibit 1 below shows that for the week ending June 27, about 69% of skilled nursing facilities have reported vaccination data to CMS. Regionally, the highest rate of fully vaccinated residents in skilled nursing facilities reporting vaccination data to CMS was seen in the Northeast at 82.4%, followed by the Midwest (80.8%), the West (78.5%), and then the South (75.2%). For healthcare workers, the highest rate was seen in the West and Northeast at 62.7% and 62.3%, respectively, while the lowest rate was seen in the South at 50.3%.

There seems to be a correlation between the rise of cases and regions with low vaccination rates. For instance, the South region, where vaccination rates among staff are relatively lower, reported the highest case count of newly confirmed cases among staff. The South is the only region that reported an increase in cases among staff week-over-week, up of 17%, from 190 confirmed cases on June 20 to 222 on June 27.

Exhibit 1 – Vaccination rates within skilled nursing facilities – By region.

By Region

Drilling deeper into states, Exhibit 2 below shows that 27 states reached a vaccination rate among skilled nursing residents above 80%, while 26 states had a vaccination rate among staff below 60%. Vermont has the highest percentage of its skilled nursing patients fully vaccinated against COVID-19 at 95%. Other states with a vaccination rate among skilled nursing residents of 90% or above include New Hampshire, Maine, North Dakota, Iowa, and Nebraska.

Separately, case trends among the general population in Alabama are concerning. According to data from the CDC compiled by NIC’s Skilled Nursing COVID-19 Tracker, weekly confirmed cases increased by 123% from 644 on June 20 to 1,438 on June 27, the highest increase seen week-over-week. Notably, Alabama has the lowest vaccination rate among the general population, only 33.3% of the population are fully vaccinated as of July 11.

Despite the increasing case rates in the general population, skilled nursing facilities in Alabama continued to be safe, reporting two cases among residents and seven cases among staff on June 27. About 79% of skilled nursing residents and 49% of staff are fully vaccinated in the state.

Exhibit 2 – Vaccination rates among skilled nursing patients and staff – By state and territory.

Vaccination Rates Among Skilled Nursing Facilities Workers Continue to Lag-1

In summary, weekly COVID-19 cases among skilled nursing patients are at the lowest level since the onset of COVID-19 and continue to trend lower or flatten with relatively small increases across a few states. Additionally, 99% of skilled nursing facilities reported no new COVID-19 cases among residents for the week ending June 27. Cases among staff are up slightly for the first time since mid-April, up 3% from 492 cases on June 20 to 509 on June 27. Data continue to suggest that vaccines are still effective, but it is important to note that over 20% of skilled nursing staff have declined a COVID vaccine. The vaccine hesitancy and reluctance among staff may lead to Delta variant pockets with severe cases in some parts of the country.

As a backdrop, Israel began administering a third dose of the Pfizer vaccine to provide coronavirus booster shots and raise antibody levels among at-risk adults. While healthcare officials in the U.S. haven’t made a statement about a third shot yet, skilled nursing facilities need to be prepared in case infection rates and hospitalizations rise among vaccinated residents.

To gain in-depth insights and track vaccination rates and the week-over-week change rate for new resident cases and fatalities of COVID-19 within skilled nursing facilities at the state and county levels, visit You can also access the Skilled Nursing COVID-19 Tracker along with a rich trove of analysis and insight on the NIC COVID-19 Resource Center.

About Omar Zahraoui

Omar Zahraoui, Principal at the National Investment Center for Seniors Housing & Care (NIC), is a seniors housing research professional with expertise in providing quantitative analysis and insights on seniors housing & care market data; building new products and reporting capabilities, including dashboards and proformas for clients and internal stakeholders; and implementing new processes and data solutions. Prior to his current role, Zahraoui worked as a data analyst, at Calpine Corporation, supporting the development of new-business strategy initiatives, analyzing sales and financial data, and developing statistical modeling of consumers’ behaviors to drive business performance. Zahraoui holds a Bachelor’s degree in Business Administration with concentrations in Finance and Management, a Master in Corporate Finance from IAE Lyon School of Management at Jean Moulin Lyon III University in France, and a Master of Science in Management Information Systems and Data Analytics from Pace University.

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