CMS has released guidance and survey procedures for the 25 states where its COVID-19 vaccination mandate for healthcare workers is not currently blocked.
The guidance, released Dec. 28 to state survey agency directors, outlines enforcement action thresholds that CMS said will help surveyors in assessing compliance.
The guidance does not apply to 25 states where the mandate is blocked: 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.
A CMS spokesperson told Becker's facilities in these states are not required to comply with the rule, pending future developments in litigation. However, the rule does currently apply to facilities participating in the Medicare and Medicaid programs in the remaining 25 states, Washington, D.C., and the territories.
According to the guidance, facilities are compliant if, by Jan. 27, they have established policies and procedures for ensuring that eligible staff are vaccinated, and all staff have received at least one dose, have a pending request for an exemption, have been granted a qualifying exemption, or have been identified as having a temporary delay as recommended by the CDC.
By Feb. 28, eligible staff must have completed the vaccination series (one dose of Johnson & Johnson or two doses of Pfizer or Moderna), have been granted an exemption or have been identified as having a temporary delay as recommended by the CDC.
CMS said federal, state, accreditation organization and CMS-contracted surveyors will begin surveying for compliance 30 days after publication of the guidance.
Facilities that fail to maintain full compliance within 90 days after publication of the guidance may be subject to enforcement action, with termination of participation from the Medicare and Medicaid programs as a final and last resort. CMS said the agency seeks to bring healthcare facilities into compliance, and "termination would generally occur only after providing a facility with an opportunity to make corrections and come into compliance."
CMS released the guidance as the U.S. Supreme Court has scheduled a special hearing Jan. 7 to consider cases involving the mandate for healthcare workers and the Occupational Safety and Health Administration's vaccinate-or-test requirement for large businesses.
The nation's highest court will make a final ruling on the mandate for eligible staff at healthcare facilities. President Joe Biden's administration has asked that the court allow the mandate to take effect across the country.
More information about the guidance is available here.