CMS answers common questions about vaccination rule: 11 takeaways

By ensuring all eligible staff members are fully vaccinated against COVID-19, healthcare facilities can help stabilize the healthcare system and eliminate potential incentives for staff to move to different settings or to different states, CMS said Nov. 10 during a call about the agency's new vaccination rule.

The vaccination requirement will also "ensure that a significant number of healthcare staff are vaccinated across [healthcare] settings, reducing staff quarantines and improving safety no matter where patients seek care," Lee Fleisher, MD, CMO and director of CMS' Center for Clinical Standards and Quality, said during the call.

Along with discussing whether the requirement will exacerbate staffing shortages, CMS also addressed common questions related to the Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule, including how the agency intends to address vaccination of surveyors tasked with ensuring compliance with Medicare and Medicaid health and safety regulations.

Here are 11 takeaways from Dr. Fleisher:

1. CMS will issue additional guidance for federal, state and CMS-contracted surveyors. 

2. CMS expects healthcare facilities covered under the vaccination rule to use available tools such as education and vaccination clinics to support employees in getting the shots. The agency encourages facilities, where possible, to consider onsite vaccination programs to reduce transportation concerns and other potential barriers to vaccination.

3. Staff who have COVID-19 antibodies are not exempt from CMS requirements. In explaining the reasoning behind the decision, the agency cited available evidence from the CDC and others indicating that the vaccines offer better protection than natural immunity.

4. The Equal Employment Opportunity Commission's website has additional information about situations that may warrant accommodations for an unvaccinated staff member with an exemption. Physical distancing and testing are among the examples of possible accommodations. 

5. Healthcare facilities covered under the CMS rule must allow medical and religious exemptions. For medical exemptions, facilities must ensure documentation is signed and dated by a licensed practitioner. For religious exemptions, facilities must ensure the exemption requests are documented and evaluated based on applicable federal law.

6. CMS does not have different requirements for current and new eligible staff members. Workers at all healthcare facilities included in the regulation must be fully vaccinated by Jan. 4.

7. The CMS vaccination rule applies to pharmacies that go onsite to covered facilities. 

8. Staff who work in assisted living facilities are required to be vaccinated if they also work in a nursing home. Assisted living facilities are not regulated by Medicare conditions of participation and are not included in the CMS rule. However, the CMS rule requires staff who provide care, treatment or other services for a nursing home and/or its residents to be vaccinated.

9. Emergency services workers are not directly subject to the CMS rule. The rule could apply to some EMS providers, though, because of their professional relationship with a CMS-regulated healthcare entity. 

10.  While the CMS requirement includes ambulatory surgery centers, it does not include physician offices. Still, if a physician provides care onsite at an ASC, the physician will have to be inoculated.

11. The CMS rule does not apply to Medicaid home care services, such as home and community-based services, or to visitors.

Read more about the CMS rule here and here

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