CMS requires nursing homes offer COVID-19 vaccines, education

Long-term and intermediate care facilities will have to educate their residents, clients and staff about COVID-19 vaccines and offer such vaccines to those populations when available, according to a CMS interim final rule published Tuesday.

If those facilities don’t provide the required education and vaccinations, the agency could bar them from participating in Medicare or Medicaid. The rule also requires long-term and intermediate care facilities to report the COVID-19 vaccination status of their residents and staff to the Centers for Disease Control and Prevention.

“The new vaccination reporting requirement will not only assist in monitoring uptake amongst residents and staff, but will also aid in identifying facilities that may be in need of additional resources and/or assistance to respond to the COVID-19 pandemic,” CMS said in a statement.

The agency touted the move, saying it would advance health equity and combat vaccine hesitancy.

“These new requirements reinforce CMS’ commitment of ensuring equitable vaccine access for Medicare and Medicaid beneficiaries,” CMS Chief Medical Officer Dr. Lee Fleisher said in a statement. “Today’s announcement directly aids nursing home residents and people with intellectual or developmental disabilities who have been disproportionately affected by COVID-19. Our goal is to increase COVID-19 vaccine confidence and acceptance among these individuals and the staff who serve them.”

The changes follow recent CDC guidance that recommends prioritizing the vaccination of people living in congregate settings, which are also known as residential habilitation settings.

“People living and working in these living situations may have challenges with social distancing and other mitigation measures, like mask use and handwashing, that help to prevent the spread of SARS-CoV-2,” the rule said. “Some congregate living residents require close assistance and support from facility staff, which further reduces their ability to maintain physical distance.”

The interim final rule takes effect May 21. Comments on it are due in June.

CMS asked the public to comment on whether it could realistically carry out similar requirements for other congregate settings, including psychiatric residential treatment facilities, psychiatric hospitals, forensic hospitals and inpatient hospice facilities.

The agency considered extending the requirements to other facility types but decided not to because it didn’t think those requirements were workable now. Instead, CMS said it would focus on facilities with longer-term patient relationships because they’re better able to administer and track multi-dose vaccines.

“Individuals in psychiatric hospitals, for example, may only be inpatients for short periods, making appropriate provision of a two-dose vaccine series challenging,” the rule said. “Although a one-dose vaccine product is also now authorized … we are not able to guarantee sufficient availability of single-dose COVID-19 vaccines at this time, or in the near future.”