CMS has published the much-anticipated rule on COVID-19 vaccinations for health care workers. Long term care facilities and a list of other Medicare and Medicaid-certified provider and supplier types must establish a policy ensuring all eligible staff have received the first dose of a two-dose COVID-19 vaccine or a one-dose COVID-19 vaccine prior to providing any care, treatment, or other services by December 5, 2021. All eligible staff must have received the necessary shots to be fully vaccinated – either two doses of Pfizer or Moderna or one dose of Johnson & Johnson – by January 4, 2022.

The rule does not include a testing requirement for unvaccinated staff. CMS has also published an FAQ document about the rule. The agency has not yet issued a QSO memo; we will share that information as soon as its available.

The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law.

CMS will ensure compliance with these requirements through established survey and enforcement processes. If a provider or supplier does not meet the requirements, it will be cited by a surveyor as being non-compliant and have an opportunity to return to compliance before additional actions occur.

The requirements apply to: ambulatory surgical centers, hospices, programs of all-inclusive care for the elderly, hospitals, long term care facilities, psychiatric residential treatment facilities, intermediate care facilities for individuals with intellectual disabilities, home health agencies, comprehensive outpatient rehabilitation facilities, critical access hospitals, clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), community mental health centers, home infusion therapy suppliers, rural health clinics/federally qualified health centers, and end-stage renal disease facilities. Click here to view the interim final rule. CMS has also issued a list of frequently asked questions. The FAQ addresses questions related to which staff are covered by the requirement, the definition of fully vaccinated and boosters, exemptions, and enforcement.

There is a question specific to assisted living facilities:

1. What about Assisted Living Facilities, Group Homes, or other similar settings?

A: This regulation only applies to Medicare and Medicaid-certified facilities. CMS does not have regulatory authority over care settings such as Assisted Living Facilities or Group Homes. This regulation will also not apply to physician’s offices because they are not subject to CMS health and safety regulations.

VHCA-VCAL has sent an inquiry to DSS to ask if the agency will be preparing guidance to ALFs on the vaccine mandate.