The Centers for Medicare & Medicaid Services (CMS) issued a rule requiring COVID-19 vaccinations for workers in most healthcare settings participating in the Medicare and Medicaid programs. The Omnibus COVID-19 Healthcare Staff Vaccinations rule became effective November 5, 2021. All eligible workers must be fully vaccinated by January 4, 2022.
Who’s required to follow this COVID-19 vaccine mandate?
The rule applies to eligible staff members who work at a facility that participates in the Medicare and Medicaid programs regardless of clinical responsibility or patient contact. This holds true for existing and new staff.
Applicable staff includes:
- Facility employees
- Licensed practitioners
- Students
- Trainees
- Volunteers
This COVID-19 vaccine requirement applies to the following Medicare and Medicaid-certified provider and supplier types:
- Ambulatory surgery centers
- Community mental health centers
- Comprehensive outpatient rehabilitation facilities
- Critical access hospitals
- End-stage renal disease facilities
- Home health agencies
- Home infusion therapy suppliers
- Hospices
- Hospitals
- Intermediate care facilities for individuals with intellectual disabilities
- Clinics
- Rehabilitation agencies
- Providers of outpatient physical therapy
- Speech-language pathology services
- Psychiatric residential treatment facilities
- Programs for all-inclusive care for the elderly organizations.
- Rural health clinics/federally qualified health centers
- Long-term care facilities
Any staff members interacting with other staff, patients, residents, or clients in off-site locations such as private residences must be vaccinated. Staff members who have previously had COVID-19 are not exempt from these requirements, regardless of whether they have measurable antibodies.
Who’s exempt from this CMS COVID-19 vaccine mandate?
Provider and supplier types that are excluded from the rule include:
- Religious nonmedical healthcare institutions
- Organ procurement organizations
- Portable X-ray suppliers
Organ procurement organizations and portable X-ray suppliers might be indirectly included in the vaccination requirements via their service arrangements with hospitals or any other providers and suppliers included under this rule.
The following facilities are also excluded because they are either not covered or regulated under CMS health and safety regulations:
- Assisted living facilities
- Group homes
- Home and community-based services
- Schools that receive Medicaid funding
People who provide entirely remote services and who don’t have any direct contact with other staff and patients are exempt from the rule and are not required to be vaccinated.
Facilities can also establish processes for staff to request religious or medical exemptions from the COVID-19 vaccination regulations.
This COVID-19 vaccine mandate was implemented in two phases:
- Phase 1: Within 30 days after the regulation was published, staff members at all applicable healthcare facilities must have had, at a minimum, the first dose of a primary series or a single dose of COVID-19 vaccine before providing any services.
- Phase 2: All applicable staff members must complete the primary vaccination series within 60 days of the regulation’s publication. Staff members granted exemptions from the COVID-19 vaccine are excluded from this phase.
CMS considers staff members fully vaccinated if it has been two weeks or longer since they completed a primary vaccination series. CMS wants state survey agencies to conduct onsite compliance reviews of these vaccination requirements. The agencies are supposed to assess the vaccination statuses of staff members on all surveys. Surveyors will assess the regulated facility’s COVID-19 vaccination policies. They will also survey the number of resident and staff COVID-19 cases over the previous four weeks and review a list of all staff members and their vaccination statuses. Surveyors will also conduct interviews. Their findings will determine the facility’s compliance with these regulations.
In addition, accrediting organizations must update their survey procedures to assess facilities for compliance with vaccination requirements.
What are the penalties for non-compliance with this CMS COVID-19 vaccine mandate?
CMS wishes to work with non-compliant healthcare facilities to bring them into compliance. However, they might penalize facilities that ignore the regulations.
Beginning in 2022, nursing homes, home health agencies, and hospice facilities might incur monetary penalties, denial of payment, and even termination from the Medicare and Medicaid programs if they are found non-compliant with the requirements.
Hospitals and certain other providers will be allowed to become compliant. If they do not, they may be terminated from the Medicare and Medicaid programs.
Final notes regarding this CMS COVID-19 vaccine mandate:
The CMS COVID-19 Omnibus Staff Vaccination Requirements take priority over other federal vaccine requirements. They also preempt any state law preventing a facility from complying with vaccination regulations. It’s recommended that healthcare organizations share this information with their staff. Affected organizations should have already instituted a process to implement vaccination requirements to ensure compliance.
Please visit CMS COVID-19 Omnibus Staff Vaccination Requirements for additional details. If you have any questions, please get in touch with us or CMS.
More information about Fifth Avenue Healthcare Services
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