Why Senior Living Operators Should Pay Attention to CDC Turmoil

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This week, Dept. of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. demanded the firing or resignation of CDC director Susan Monarez in a move that alarmed public health experts.

Also earlier this week, rumors swirled over whether the Centers for Disease Control and Prevention (CDC) might pull the Covid-19 vaccine off the market altogether within months. Another U.S. agency, the Food and Drug Administration (FDA), also this week narrowed its guidelines for who should get the Covid-19 vaccine to adults aged 65 and older and people with risk factors like obesity or a history of smoking.

The recent attempted firing, walk-outs and exodus of top CDC staff and potential forthcoming changes in vaccine authorization paint a troubled picture at the public health agency. Kennedy himself said as much when he told Fox News Thursday that he is “fixing” the CDC, “and it may be that some people should not be working there anymore.”

Skilled nursing operators whose payment is tied to federal reimbursements from HHS know well the impact of government agency dysfunction. Traditional senior living operators charge residents mostly private-pay rates, and thus are more isolated from such government turmoil.

But the CDC played an important role in the senior living industry’s initial pivot from stay-in-place restrictions to reopening to the world. State governments, supported by guidance from the CDC, helped operators determine what to do and not to do to keep residents well while information was sparse. Thinking back to 2021, I remember the optimism and hope that senior living leaders felt as they rolled up their sleeves and joined residents and staff in getting their first vaccine doses. In 2025, I worry that moment may now be eclipsed by rash decisions driven by new and unfounded vaccine skepticism from public health leaders, and that it will leave senior living operators — not to mention the wider country — more susceptible to sickness in the end.

In the last few years, I have talked with many senior living leaders who have pivoted from the “Covid days” to more hopeful growth and evolution efforts. And it’s not uncommon to hear people at senior living conferences bemoaning mention of “the C-word,” at least in my experience.

But new Covid-19 cases are still cropping up every day across the U.S. As I write this Update, a Covid variant called “Stratus” is leading to a new boom of infections in many states. While deaths from Covid are far lower than they were five years ago, people coming down with the disease still sometimes grapple with symptoms for months or years. And even if communities aren’t shutting down for weeks on end like in the darkest days of 2020, Covid can still cause disruptions in other, smaller ways, such staff calling in sick or residents staying home for longer.

Whether operators like it or not, Covid is still a force to be reckoned with in their communities. Given that the CDC once helped senior living operators through a tough period, I think the industry should be at least somewhat concerned about the turmoil at the top of the agency, if it is not already. Although there are additional legal hurdles the Trump administration would have to follow to further restrict the Covid-19 vaccine or take it off the market, even the mere discussion of restricting a life-saving vaccine is alarming to me personally. I also worry the problem could extend beyond Covid and into potentially other important vaccines that senior living operators use to keep residents safe.

In this members-only SHN+ Update, I analyze the CDC’s recent problems along with history and offer the following takeaways:

• A look back to how the Covid-19 vaccine started the senior living industry’s latest recovery
• Why accessing the Covid-19 vaccine and other vaccines is important for the senior living industry’s future
• How CDC turmoil imperils the industry’s ability to respond to other endemic diseases or outbreaks

Covid-19 vaccine played vital role in industry’s recovery

Days before Christmas in 2020, I was talking on the phone with then-Atria CEO John Moore. Atria was among the very first senior living operators in the U.S. to begin doling out Covid shots to residents in its communities, and I still remember the excitement and hope in his voice as he described the company’s ongoing rollout. In the months and years following that moment, countless senior living operators arranged vaccine clinics for residents on ambitious timelines.

Photo courtesy Holiday Retirement Photo courtesy Holiday Retirement

Today, the data shows that they were right in doing so. A 2023 study from NIC and NORC at the University of Chicago found that, after the first Covid vaccines were available, older adults living in congregate senior living communities did not have a higher risk of dying from the disease compared to older adults living in non-congregate settings, such as at home.

While that might not seem so impressive on its face, keep in mind that senior living communities were like tinder for the fast-spreading pandemic given the closer proximity of residents to each other and staff, and that people 65 and older are at higher risk of severe disease.

The NIC/NORC study showed that senior living communities could actually keep older adults about as safe from the disease as if they were living alone, even while those residents lived closer to one another. CCRCs in particular had even lower levels of death than that, according to the researchers.

Covid-19 initially amounted to a massive PR hit for senior living operators and skilled nursing providers as many residents delayed their move for longer. Fast-forward to 2025 and many operators have been able to win back the trust of skeptical residents, reflected in higher occupancy in their communities. Better resident health care and infection control have been important operational tools used to win back that trust.

Today, older adults are moving into senior living communities at record rates in part due to a historically low rate of new construction, and I assume at least some of the older adults who delayed moving in during the Covid-19 pandemic are now living in a senior living community.

But I also believe that part of that demand stems from a belief that senior living communities are as ready as any other health care setting to stop Covid outbreaks before they start. To that end, I do think operators are better equipped now than ever before to handle resident health needs and the possibility of spreading infections. But I also think the Covid vaccine – or at least the perception that more people now are vaccinated – has helped the pandemic fade into the background, and its absence would be felt.

As of the end of 2024, about 49% of adults 75 years and older had received one dose of the COVID-19 vaccine for 2024 and 2025, according to the CDC. For now, vaccine makers Moderna and Pfizer are still shipping their latest doses on schedule and as planned for the fall and 2026.

I don’t think the senior living industry will find itself back in the early days of 2020 given all it has learned about infection control. But I do wonder about the wider public health implications of all of this and what that could mean for the future. Dr. Tina Tan, who is president of the Infectious Disease Society of America and also professor of pediatrics and infectious diseases at Northwestern University, told NPR this week she is “worried that this puts the entire American population at risk for severe COVID disease and the complications associated with it.”

With more barriers in place, people – older adults included – might not be able to get insurance to pay for the vaccine or in other cases, their doctors and pharmacists may refuse to prescribe or administer them.

“You’re going to see an increase in the number of individuals that are hospitalized or that potentially could die,” Tan told NPR.

CDC turmoil comes with other potential worries

While Covid-19 is a chief concern given reports of possible vaccine restrictions, the turmoil at the government agencies also calls into question how well the agency can support senior living companies with other endemic health struggles, such as the flu, RSV and norovirus. And it seems that even with that preparation, those diseases can hit hard enough to impact occupancy. Just this past quarter, two publicly traded REITs, Ventas (NYSE: VTR) and NHI (NYSE: NHI) reported higher-than-expected resident move-out rates related to deaths.

Public health information flows from the CDC to the 50 U.S. states, and from there, to pharmacies and health practitioners. Trilogy Health Services currently works with its pharmacy partners to hold vaccination clinics for not just Covid, but RSV and other respiratory illnesses. According to Dr. Andrew McNamara, the operator’s chief medical officer, Trilogy has grappled with creating solid policies as the various states the company is located in have taken different approaches to CDC vaccine and masking recommendations.

“The more you can do to encourage that culture within your building, [the better],” he said during a panel at RETHINK. “Based on location, how they interpreted some of the vaccines and the stuff that happened during the pandemic, they’re a little jaded. It can be hard to say, ‘Hey, this RSV thing is really important now.’”

Even with guidance from the government, operators don’t always have an easy time parsing that information, especially if they are in multiple states. I don’t think firings or an exodus of CDC leaders will help that process, at the very least. But it could make it harder for senior living operators or their partners to access the information they need to keep their residents and staff safe.

It’s still unclear what the federal agency might ultimately do in the end, and that uncertainty is its own problem. I do believe that some states will help fill the gap if the CDC’s vaccine apparatus atrophies. For example, Illinois Governor J.B. Pritzker is reportedly exploring buying Covid vaccines in bulk due to confusion about the road ahead, with the intention of distributing them statewide.

Putting states aside, signs point to an even larger vaccine and national public health shakeup ahead. Kennedy has so far in his tenure filled the CDC with his own cadre of Covid-19 response skeptics and vaccine deniers, and Monarez apparently clashed with Kennedy over “the systematic dismantling of public health institutions, the silencing of experts, and the dangerous politicization of science,” according to the New York Times.

While the entire world is still weary from the last five years, other health issues potentially loom on the horizon, and not just Covid. Although the senior living industry has emerged healthy from its first pandemic, that was with the help of public health leaders, and there is no guarantee that it will fare so well during the next one should they lack that support in the future.

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