The Centers for Medicare and Medicaid Services (CMS) on May 11 issued an Interim Final Rule on COVID-19 Vaccine Requirements. The rule applies to residents, clients, and staff of Long Term Care (LTC) facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID) and focuses on new education and data-gathering initiatives tied to the vaccination effort.

CMS also published a QSO memo to state survey agencies on how to operationalize this new requirement. The rule is scheduled to go into effect on May 21, which is 10 days from its publication in the Federal Register.

This rule specifies that LTC facilities must develop and implement policies and procedures to:

• Educate all residents and staff about COVID-19 vaccines;

• Offer vaccination to all residents and staff; and

• Report to the Centers for Disease Control and Prevention (CDC) via National Healthcare Safety Network (NHSN) certain data regarding vaccination status for residents and staff as well as any therapeutic treatments (for example, monoclonal antibody use). Note that this requires additional reporting via NHSN modules: reporting the Resident Therapeutics Pathway found on COVID-19 LTCF Module, as well as reporting via the Weekly HCP and Resident COVID-19 Vaccination Module.

Additionally, CMS said ICF-IID facilities must educate all clients and staff about COVID-19 vaccines and offer vaccination to all clients and staff. The agency said reporting is not required for ICFs-IID; however, CMS strongly encourages voluntary reporting.

In response, David Gifford, MD, chief medical officer of AHCA/NCAL, said the LTC profession has been supportive of publicly reporting COVID-19 vaccination rates in long term care since the vaccines were first approved, and it greatly appreciates CMS taking this step today.

“Reporting vaccination rates is critical to facilitating in-person visitations in nursing homes, tracking the effectiveness of the vaccines, and helping ensure the industry meets our goal to vaccinate 75 percent of staff by the end of June,” he said.

Gifford also said “it is important that we not judge facilities with low vaccination rates, but instead seek to understand whether additional resources or outreach can be done to encourage more staff and residents to get the vaccine, or help facilities acquire additional vaccines for new patients and hires.”

He said the LTC profession believes transparency on vaccination rates should be expanded to all Medicare providers, including hospitals, home health, and inpatient rehabilitation facilities, where many seniors may also receive care and the virus can still remain a threat.
“All Medicare providers should have a streamlined effort to report their vaccination rates,” Gifford said.

The comment period for the interim final rule closes July 12. CMS is also requesting feedback on the feasibility of implementing similar requirements in other long term care settings that accept Medicare or Medicaid payments, including assisted living.