The Centers for Medicare & Medicaid Services on Friday announced vaccination requirements and timelines for 24 states where a federal mandate was allowed to go forward by this week’s Supreme Court decision.
States must ensure workers have at least one vaccination within 30 days, the agency said in a memo to state investigators late Friday. He added that employees in newly covered states must be fully vaccinated by March 15. The rule covers anyone in a patient-facing position at more than 15,000 nursing homes that accept Medicare or Medicaid funding.
Facilities with more than 80% of workers vaccinated at 30 days and a plan to achieve a 100% staff vaccination rate within 60 days would not be subject to additional enforcement actions, the agency said.
“States should work with their CMS location for cases that exceed these thresholds, but pose a threat to patient health and safety,” CMS wrote. “Installations that do not meet these parameters could be subject to additional enforcement actions depending on the severity of the deficiency and the type of installation (for example), remediation plans, monetary civil penalties, denial of payment, termination, etc..”
The memo largely mirrors compliance guidelines issued Dec. 28 for 25 other states, Washington, DC and the territories, following the removal of an earlier injunction by a lower federal court. CMS Administrator Chiquita Brooks-LaSure said Thursday that the Supreme Court’s decision would not affect enforcement timelines for those vendors, whose workers must have at least one COVID-19 vaccine by January 27, with full vaccination required by February 28..
States included in the latest compliance memo include: Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia and Wyoming.
An official CMS spokesperson said McKnight Friday that the agency is moving “full speed,” adding that a preliminary injunction still applies in Texas.
Also on Friday, CMS acknowledged that it had refined its estimates of the number of workers who would be covered by its rule. When the rule was first announced in November, federal officials estimated that about 17 million, or 80% of America’s 22 million healthcare workers, would be required to get vaccinated. In its regulatory impact analysis and in a statement released yesterday, the agency lowered that estimate to 10.4 million employees.
Friday’s new guidelines follow split Supreme Court rulings on Thursday on vaccination mandates for millions of American workers. The High Court voted 5-4 to lift two injunctions and allow the CMS healthcare workers’ mandate to go ahead while appeals take place in the lower courts. The justices also blocked, by a 6-3 vote, a broader mandate issued by the Occupational Safety and Health Administration for companies with 100 or more employees.
Although staff providing telemedicine or support services outside the facility are not subject to the mandate, CMS recalled on Friday that most other staff are.
“Regardless of clinical responsibility or resident contact, policies and procedures must apply to…. facility staff, who provide care, treatment or other services to the facility and/or its residents,” the CMS memo reads. It lists data subjects as: facility employees, licensed practitioners, students, interns, volunteers, and “persons who provide care, treatment or other services to the facility and/or its residents, under contract or by other arrangement”.
Please check for updates to this developing story.