The Centers for Medicare & Medicaid Services (CMS) is in the “rulemaking” stage of its development of a federal vaccine mandate for all health care workers employed by Medicare or Medicaid funded facilities, according to a CMS official.
Dr. Lee Fleisher, CMS’ chief medical officer and director of the Center for Clinical Standards and Quality (CCSQ), said on a Zoom call during the National Association for the Support of Long-Term Care Support (NASL) annual meeting held in Washington, D.C. that he spent the morning reading the rule his team is currently developing.
Fleisher said CMS is on track to issue its guidance regarding the vaccine mandate in late October, and the government agency has worked alongside the Occupational Safety and Health Administration (OSHA) in its development.
“We have worked closely with our partners at OSHA to think about how the two rules, since there are two that could affect any facility, are really integrated,” Fleisher said.
President Joe Biden last month built upon his initial calls requiring nursing home staff to be vaccinated by expanding it to include any health care provider that receives Medicare or Medicaid funding.
The expansion includes hospitals, home-health agencies, ambulatory surgical settings and dialysis centers, among others.
Biden also said that all companies with more than 100 workers needed to require vaccination or weekly testing, and ordered OSHA to draft a rule that would make those requirements enforceable.
While there remain many questions and few answers as to what the mandate might look like and whether there will be some kind of alternative, even in the short-term, Fleisher said CMS is taking into consideration both the potential risk of infection to patients as well as the care a patient might receive based on staffing levels.
“I went and visited a nursing home … and I heard about how bad the mandates in Philadelphia, versus the lack of mandates in other areas, was leading to disparities in who took care of patients who were getting more of an all vaccinated in one place and a very large percentage of unvaccinated staff in others,” Fleisher said. “That’s an inequity … and that’s one of the things that as we were briefing the administrator and the secretary, we did discuss.”
In the meantime, several operators and state governments have implemented their own vaccine mandates. Back in July, Evangelical Lutheran Good Samaritan Society announced that all employees would have to be vaccinated by Nov. 1.
In New York, about 97% of skilled nursing facility staff were vaccinated as of Oct. 10. The state imposed a deadline of Sept. 28 for nursing home staff, whereas home care, hospice and adult care workers had until Oct. 7.
Kennett Square, Pa.-based Genesis HealthCare announced at the end of August that it had vaccinated all of its staff, barring those with medical or religious exemptions.
Genesis workers — approximately 40,000 across more than 200 facilities — were required to get the first shot of Pfizer or Moderna, or the single-dose Janssen COVID-19 vaccine by Aug. 23; Second shots were to be completed by Sept. 22, the nursing home provider said.
While Genesis said it met the first deadline under its COVID-19 inoculation policy announced earlier this month, it did not reveal how many employees were terminated as part of its mandate.
Companies featured in this article:
Centers for Medicare & Medicaid Services, Evangelical Lutheran Good Samaritan Society, Genesis HealthCare
