vaccine mandate for healthcare workers

The Centers for Medicare & Medicaid Services Friday announced vaccination requirements and timelines for 24 states where a federal mandate was allowed to move forward by this week’s Supreme Court decision.

States must ensure workers have at least one vaccination within 30 days, the agency said in a memo to state surveyors late Friday. It added that employees in the newly covered states must be fully vaccinated by March 15. The rule covers anyone in a patient-facing position in more than 15,000 nursing homes accepting either Medicare or Medicaid funding.

Facilities with more than 80% of workers vaccinated at 30 days and a plan to achieve a 100% staff vaccination rate within 60 days would not be subject to additional enforcement action, the agency said.

“States should work with their CMS location for cases that exceed these thresholds, yet pose a threat to patient health and safety,” CMS wrote. “Facilities that do not meet these parameters could be subject to additional enforcement actions depending on the severity of the deficiency and the type of facility (e.g)., plans of correction, civil monetary penalties, denial of payment, termination, etc..”

The memo largely mirrors compliance guidance issued Dec. 28 for 25 other states, Washington, D.C, and territories, following the removal of an earlier injunction by a lower federal court. CMS Administrator Chiquita Brooks-LaSure said Thursday the Supreme Court court ruling would not affect enforcement timelines for those providers, whose workers must have at least one COVID-19 shot by Jan. 27, with full vaccination required by Feb. 28.

States included in the latest compliance memo include: Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia, and Wyoming.

A CMS official spokesman told McKnight’s Friday that the agency is moving “full speed ahead,” adding that a preliminary injunction still applies in Texas.

Also Friday, CMS acknowledged it had refined its estimates of how many workers would be covered by its rule. When the rule was first announced in November, federal officials estimated some 17 million, or 80% of 22 million U.S. healthcare workers, would be required to get vaccinated. In its regulatory impact analysis and in a statement issued yesterday, the agency lowered that estimate to 10.4 million employees.

Friday’s new guidance comes on the heels of the Supreme Court’s split rulings Thursday on vaccine mandates concerning millions of U.S. workers. The High Court voted 5-4 to lift two injunctions and allow the CMS healthcare worker mandate to move forward while appeals play out in lower courts. Justices also blocked, by a 6-3 vote, a broader mandate issued by the Occupational Safety and Health Administration aimed at companies with 100 or more employees.

While staff providing telemedicine or support services outside of the facility are not subject to the mandate, CMS reminded Friday that most other personnel are.

“Regardless of clinical responsibility or resident contact, the policies and procedures must apply to …. facility staff, who provide any care, treatment, or other services for the facility and/or its residents,” the CMS memo said. It listed applicable individuals as: Facility employees, licensed practitioners, students, trainees, volunteers, and “individuals who provide care, treatment, or other services for the facility and/or its residents, under contract or by other arrangement.”

Please check back for updates to this developing story.