The Centers for Medicare & Medicaid Services (CMS) issued a revised guidance on healthcare staff COVID-19 vaccination that gives nursing homes more leeway so long as “good faith efforts” are being made to achieve compliance.
The agency’s staff vaccination requirements have been in effect across all states since Feb. 20 after legal challenges from several states were shot down by the Supreme Court. Noncompliance with the requirements could lead to enforcement including termination of participation in Medicare and Medicaid.
Citing “relatively low” COVID-19 hospitalizations and deaths nationwide, Wednesday’s revised guidance memo to surveyors loosens the language around long-term care and skilled nursing facilities’ 100% staff vaccination compliance requirement.
The agency said it now defines noncompliance as “facility staff vaccination rates under 100% of unexcepted staff,” bringing the requirement in line with those for other facility types.
Further, noncompliance with the requirement doesn’t always require enforcement, the agency wrote. Surveyors are now instructed to cite the severity of facilities' noncompliance and whether they are demonstrating a good faith effort to correct noncompliance in line with a submitted plan of correction.
“For example, a facility that is non-compliant and has implemented a plan to achieve a 100% staff vaccination rate would not be subject to an enforcement action,” CMS wrote in the updated guidance regarding long-term care and skilled nursing facilities.
Conversely, surveyors should issue a harsher citation in “situations indicating egregious noncompliance,” the agency wrote. Examples of this “could include more than 50% of staff being unvaccinated (unless exempted, or temporarily delayed), and/or no policies or procedures as required,” according to the memo.
CMS gave similar updates on the noncompliance severity citations and good faith efforts to surveyors of other facility types, including hospitals and ambulatory surgical centers. It also stressed that surveyors should be monitoring other infection prevention and control practices regardless of the facility’s vaccination compliance.
States that opposed the administration’s vaccine requirement filed an appeal with the top court in May, which was declined earlier this month when the Supreme Court unveiled its docket for the term. The requirements applied to more than 10 million healthcare workers across the country, according to the administration.