Those who work in long term care in the state will have to be fully vaccinated by Jan. 4, 2022.

That’s because of a federal mandate estimated to impact millions of Americans working in health care, large companies or for the federal government.

Staff at North Dakota’s 79 nursing facilities have 30 days from today to get their first shot of the COVID-19 vaccine, or get fired.

“I think it’ll be a net good for saving lives. Absolutely,” North Dakota Long Term Care Association President Shelly Peterson said.

The mandate is for facilities getting funding through Medicare and Medicaid.

It doesn’t give employees an alternative to show a negative COVID test weekly, like the mandate toward private businesses does.

Peterson says it’s a good thing overall, but it could create staffing challenges or worse.

“I fear we may have a couple of closures only because the vaccination rates are so low,” Peterson said.

Peterson said one location has just a 23 percent staff vaccination rate, and facilities that don’t comply could face a range of fines.

“Maybe if you’re at 95 percent or something and you just have a few the fine would be lesser. If you’re down still in that 23 percent, 30 percent, we anticipate it will be a significant fine,” Peterson said.

Peterson says continuing to talk with hesitant employees is going to be key over the next few weeks.

While nursing homes will be impacted, assisted living facilities will not face the same mandate.

That includes Country House in Dickinson, which implemented its own deadline last month according to Executive Director Tessa Johnson.

“Throughout our corporation we have about 1,100 staff, and I think they told me there was less than 50 that we lost, which I think is a really good number. In my building specifically, I’ve only lost three,” Johnson said.

Johnson says doing everything possible to keep residents safe is her main priority even if it means losing staff.

“I personally, professionally fully support the vaccination. I strongly believe in the core to my soul that if it’s not for you, then I don’t think this job is for you at this point,” Johnson said.

Peterson says about a quarter of nursing facilities have a vaccine rate in the 40 to 60 percent range.

The other parts of the mandate announced Thursday would require vaccines for private businesses with more than 100 employees and mandate the shot for federal contractors.