The end of the public health emergency and the commercialization of COVID-19 vaccines has led to vaccine administration and billing challenges for nursing homes across the country. Health Services Advisory Group (HSAG), the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Arizona and California, is leveraging partnerships with state and local organizations and contracting with pharmacies to ensure those at highest risk for COVID-19 have access to the vaccine while reducing administrative burden for nursing home staff. These efforts have resulted in more than 650 vaccine clinics and the administration of more than 13,000 COVID-19 and 3,800 influenza and pneumonia vaccines to nursing home residents and staff. 

Aligning Collaboration for Enhanced Impact 

Building on established relationships with state and local health departments and nursing home professional organizations has helped HSAG engage individual nursing homes and nursing home corporations with low COVID-19 up-to-date vaccination rates. Using data from the National Healthcare Safety Network (NHSN) and its own analytic tools, HSAG efficiently identifies areas of need and prioritizes targeted interventions designed to support and educate nursing home leadership, staff, and residents.  

Reducing Administrative and Financial Burden through Coordinated Vaccine Education and Clinics 

One of HSAG's key strategies for improving vaccine administration access and addressing cost challenges is contracting with pharmacies across Arizona and California to conduct on-site vaccine clinics that bring vaccination services directly to nursing home residents and staff. Using its own vaccine clinic coordinators, HSAG streamlines coordination between the pharmacy and the nursing home requesting assistance. When contracted pharmacies are unable to get reimbursed for administering the vaccine to residents and staff, HSAG uses allocated American Rescue Plan Act (ARPA) funds approved for use by CMS to cover the cost of the vaccines. This ensures equitable vaccine access while simultaneously increasing vaccination rates. 

To request HSAG vaccine assistance, nursing homes can complete an online vaccine assistance form, and an HSAG vaccine coordinator will respond within 72 hours of submission to assess need, schedule an on-site or virtual vaccine education session, schedule a vaccine clinic, and provide NHSN data and analytics support. To date, more than half of all educational sessions resulted in a scheduled vaccine clinic. 

Empowering Nursing Homes with Educational Resources 

In addition to supporting nursing homes with vaccine administration, HSAG offers educational resources designed to support and educate nursing home leadership, staff, residents, and family members. 

• COVID-19 and Flu Vaccine Information 
  • Arizona County Vaccine Information 
  • COVID-19 mRNA Vaccines are Not as New as You Think 
  • COVID-19 Vaccine Effectiveness 
  • Flu Vaccine: Get the Facts 
  • Learn the Facts About COVID-19 Vaccines 
• Respiratory Infection Education 
  • The Roadmap to Success: Prevention of Respiratory Infection – Improving Vaccination Rates in Long-Term Care 
  • Viral Respiratory Pathogens Toolkit for Nursing Homes 
• Vaccine Education 
  • Empower Yourself and Others: Vaccine Education Event 
  • Protect Yourself from Long COVID or Post-COVID Conditions (PCC): Get Vaccinated! 
  • Q&A: Resistance to the Updated COVID-19 Vaccine 
  • Stay Home When Sick 
• Vaccine Clinic Promotion 
  • Important Announcement Template: Vaccination Education Event and COVID-19 Clinic for Our Residents 
  • Vaccine Clinic Promotional Flyer: Protect Your Loved Ones by Staying Current with Your Vaccinations 

Paving the Way for Continuous Improvement 

HSAG continues to prioritize education and outreach to the nursing homes it supports by conducting multiple educational sessions each week and providing educational resources. The implementation of the online referral process ensures that every nursing home requesting vaccination support connects to appropriate partners and pharmacies in their state and region. This allows the HSAG vaccination coordination team to provide ongoing support that fits the specific needs of nursing home staff and residents.

Keys to Success

1. Aligning Collaboration for Enhanced Impact 

2. Reducing Administrative and Financial Burden through Coordinated Vaccine Education and Clinics 

3. Empowering Nursing Homes with Educational Resources 

This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1367-05/16/24