CMS Crafting COVID Vaccine Rule for All Health Care Staff

Federal health care agencies are developing new Conditions of Participation that would require all staff of Medicare- and Medicaid-certified health care providers to be vaccinated against COVID-19. Though the White House used the term “health care facilities” in its announcement, the forthcoming rule would apply to hospice and home health care workers.

The U.S. Centers for Medicare & Medicaid Services (CMS) is collaborating with the Centers for Disease Control and Prevention (CDC) to expand the federal vaccine mandate for nursing home workers to include staff in almost every health care setting. The White House advised health care providers to begin efforts to vaccinate employees to ensure they are in compliance when the rule takes effect.

“There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health,” said U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra. “Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential.”

The administration has not announced a specific effective date, but indicated that an interim final rule would be released during October and would include a public comment period. CMS in a statement said that providers are “urged to use all available resources,” to secure staff vaccinations, including employee education and clinics.

More than 650,000 people in the United States have died as a result of COVID-19 to date, according to the CDC, including nearly 1,750 health care workers. Close to 550,000 health care workers have tested positive for the virus since the outbreak began.

The unvaccinated account for nearly 99% of recent COVID-19-associated deaths, according to an Associated Press analysis of CDC data.

“Data show that the higher the level of vaccination rates among providers and staff, the lower the infection rate is among patients who are dependent upon them for care,” said CMS Administrator Chiquita Brooks-LaSure. “Now is the time to act.”

Discussions of vaccine mandates have been top of mind for large segments of the hospice community in recent weeks. The National Hospice & Palliative Care Organization last month called for the federal government to implement a national mandate for health care workers.

“This requirement will improve health and safety for health workers, volunteers, patients, and their families,” NHPCO President and CEO Edo Banach told Hospice News. “Because it applies so broadly, it will also help address staffing challenges within the health care sector.”

A rising number of hospices are developing their own staff mandates. Examples include Hospice & Palliative Care Buffalo, the organization members of Ohio’s Hospice, Ethos Home Health & Hospice, Blue Ridge Hospice, Care Dimensions and Empath Health.

Some in the senior care space have expressed concerns about a potential employee exodus over vaccines amid industry-wide workforce shortages, including a number of home health companies and skilled nursing facility operators.

“While we are concerned about possible impacts on an already tight labor pool, the state mandate helps to level the playing field in health care employment and will hopefully help us encourage the small percentage of our workforce who has yet to be vaccinated,” Care Dimensions CEO Patricia Ahern recently told Hospice News regarding a potential state requirement in Massachusetts.