Surveyors will begin enforcement of the Centers for Medicare & Medicaid Services (CMS) vaccine mandate for half the country this month.
That’s minus states under a federal court injunction temporarily blocking the rule, according to additional guidance issued on Dec. 28.
Facilities with 80% or higher staff vaccination compliance, who also have plans to achieve 100% compliance in 60 days, won’t be subject to additional enforcement, CMS said. If facilities achieve upwards of 90% staff vaccination within 60 days, with a plan to achieve 100% compliance in yet another month, no enforcement will be taken.
In other words if nursing homes meet the agency’s 80% and 90% milestones, they effectively have 90 days to get into full compliance with the CMS mandate.
Nursing homes with staff vaccination rates under 100% will be considered non-compliant after Jan. 28, CMS said in a memo, with opportunities to return to compliance.
Surveyors shouldn’t try to implement or enforce the mandate in states that fall under federal injunctions temporarily blocking the agency rule, CMS said in its memo.
The agency appealed three court injunctions in Louisiana, Missouri and Texas – the cases, along with similar cases tied to the Occupational Safety and Health Administration (OSHA) rule, have made their way the Supreme Court with arguments scheduled for this week.
CMS guidance doesn’t apply to the following states: 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, Texas, Utah, West Virginia and Wyoming.
About 78.3% of staff per nursing home are vaccinated, according to CMS submitted data as of Dec. 12. Total staff COVID cases for the year were 696,711, and 2,184 deaths.
Original guidance published Nov. 5 required Medicare- and Medicaid-funded facilities, including nursing homes, to have all staff fully vaccinated by Jan. 4. Compliance excludes pending requests for medical and religious exemptions, which CMS has left facilities to determine themselves.
Enforcement of the rule could be seen in multiple ways depending on severity, from civil monetary penalties to denial of payments.
CMS has said it could go so far as terminating participation in Medicaid and Medicare programs.
