Image of Covid-19 vaccination record card with vials and syringe.
Image credit: Getty Images, Bill Oxford

The Centers for Medicare & Medicaid Services has rescinded guidance that says surveyors who are not fully vaccinated shouldn’t participate on the onsite survey team when inspecting certified providers. 

The agency said in a memo to state survey agencies Thursday that its switch stemmed from confusion around the possibility of penalties of noncompliance and to prevent facilities from inquiring about surveyor vaccination status — even though the initial guidance said there would be no penalties and prohibited providers from asking surveyors for proof of their vaccination. 

“We commend all the entities who have established COVID-19 vaccination programs for their surveyors, and we continue to encourage vaccination of surveyors performing federal oversight surveys,” CMS wrote in the memo. “Any questions about state survey agency or accrediting organization vaccination programs should be directed to those entities.” 

All along, long-term care providers have pushed CMS to require surveyors to be fully vaccinated before going into facilities — especially since operators were expected to comply with the healthcare worker COVID-19 vaccine vaccine mandate. Their disappointment was, therefore, no surprise Thursday.

“We are disappointed to see CMS take this step backwards, which reduces important protections for our residents from this virus. It is especially concerning as we are seeing COVID cases increase due to growing omicron sub variants,” the American Health Care Association/National Center for Assisted Living told McKnight’s Long-Term Care News in a statement. 

The association reminded that surveyors are typically in close contact with multiple residents and staff during a typical survey, including very close interactions with residents while performing interviews required by CMS survey protocol. 

“CMS rescinding vaccination expectations for surveyors who go into health care facilities sends mixed messages to staff in those facilities who are required to be vaccinated,” AHCA/NCAL said. 

The Advancing Excellence in Long-Term Care Collaborative also was dismayed about CMS’ decision and called on the agency to revise its decision, given the increasing number of COVID-19 cases in nursing homes, newer variant spreads and the Centers for Disease Control and Prevention’s recommendation for additional booster shots for older adults.

“Inspectors meet with residents and staff during their 3 to 4 day visits to nursing homes. This decision is inconsistent with the epidemiology and with the logic used by CMS to require health care staff to be vaccinated,” the organization said in a statement Thursday.

The group also said it’s concerned that this “sends a mixed message and will put residents of nursing homes at risk.”