Workers at skilled nursing and other long-term care facilities that have been suspended or are on extended leave won’t count against the providers as “unvaccinated staff,” according to new updated guidance from the federal government.
The Centers for Medicare & Medicaid Services on Tuesday issued revisions to its guidance for the COVID-19 vaccine mandate rule. CMS also emphasized that “good-faith efforts” by providers will be rewarded, and gave examples, in the guidance.
The revisions clarified that contract staff who fail to provide evidence their vaccination status reflects as being non-compliant with the rule and should be cited.
The federal vaccine rule requires facilities to ensure that staff who haven’t been fully vaccinated or are exempt adhere to additional precautions that are intended to slow the spread of COVID-19. Examples currently listed in the guidance range from reassigning them to non-patient areas, requiring weekly testing and use approved-masks on the job.
CMS on Tuesday said this requirement “is not explicit and does not specify which actions must be taken.”
“The examples above are not all inclusive and represent actions that can be implemented,” the agency wrote in the updated guidance. “However, facilities can choose other precautions that align with the intent of the regulation which is intended to ‘mitigate the transmission and spread of COVID-19 for all staff who are not fully vaccinated.’”
CMS also noted it may lower the scope and severity of a citation and/or enforcement action if it can identify if any of these actions occurred prior to the survey:
- If the facility has no or has limited access to the vaccine, and the facility has documented attempts to obtain vaccine access.
- If the facility provides evidence that they have taken aggressive steps to have all staff vaccinated, such as hosting vaccine clinics.
The agency added the following example to illustrate how providers may receive relief from good-faith efforts:
“… if the facility staff vaccination rate is 90% or more, there is no resident outbreak in the previous 4 weeks, and all policies and procedures were developed and implemented, per Table 1 this would be cited ‘D.’ However, if the facility provides evidence that it has made a good faith effort by taking aggressive steps to get all staff vaccinated, surveyors may lower the citation to ‘A.’”
The revisions were detailed late Tuesday by the American Health Care Association in an extensive blog post.
