A healthcare worker receives a COVID-19 vaccine dose
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Surveyors can now evaluate long-term care providers’ compliance with a federal COVID-19 vaccine mandate covering healthcare workers in half of the United States. Many long-term care providers are ready to meet the standards despite ongoing challenges. 

Enforcement of the regulation officially began on Thursday in states that didn’t challenge the mandate in court. Facility staff vaccination rates under 100% constitute non-compliance under the rule, according to the Centers for Medicare & Medicaid Services. 

LeadingAge, following a recent poll of its members, said most providers implemented mandates months before the federal government announced its plans and a “vast majority are ready to move forward on the CMS healthcare worker mandates.”  

“Vaccines and boosters are the most powerful tools we have in the battle against COVID-19; they save lives,” Katie Smith Sloan, LeadingAge president and CEO, said in a statement. “While mandates can sometimes make it harder for employers to keep or find qualified workers – especially as Omicron surges and workforce challenges are growing – we encourage all members, regardless of care setting or community type, to ensure staff get vaccinated.” 

To be fully compliant, providers were required to have policies in place to ensure that all facility staff are vaccinated for COVID-19 and ensure 100% of their non-exempt workers have at least one dose of the vaccine within 30 days of a Dec. 28 memo

Facilities where less than 100% of staff had received a first dose or have pending exemption requests are considered non-compliant. But any facility with a staff vaccination rate above 80% with a specific plan to achieve a 100% rate within 60 days will not be subject to additional enforcement action, CMS has said. 

After 60 days, full compliance requires facilities to have all necessary policies in place and for 100% of staff to have completed their vaccine series. Facilities with vaccination rates above 90% with a plan to achieve a 100% staff vaccination rate within an additional 30 days will not be subject to additional enforcement action.

Within 90 days and moving forward, facilities failing to maintain compliance with the 100% standard may be subject to enforcement action.

Nearly 82% of nursing home staff have been vaccinated nationwide as of Jan. 16, according to CMS. 

“Medicare- and Medicaid-certified facilities are expected to comply with all applicable regulatory requirements, and CMS has a variety of established enforcement remedies,” a spokesman told McKnight’s Long-Term Care News on Thursday. 

“For nursing homes, home health agencies, and hospice, these include civil monetary penalties, denial of payment, and even termination from the Medicare and Medicaid program as a final measure,” he added. “Termination would generally occur only after providing a facility with an opportunity to make corrections and come into compliance.”