01/27/2022
Vaccine mandate updates
On January 14, the Centers for Medicare & Medicaid Services (CMS) released the Guidance for the Interim Final Rule - Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination which applies to Ohio. Guidance specific to each provider type and certified suppliers is provided under downloads. CMS provided training on how to survey for the mandate to the state agencies. These trainings can be found on the Quality, Safety & Education Portal (QSEP). Once logged into QSEP, providers are able to access the two trainings called Surveying for the New Staff Vaccination Rule - Acute and Continuing Care Providers and Surveying for the New Staff Vaccination Rule - Long Term Care (LTC). The trainings provide examples of how surveyors will calculate percentage of vaccinated staff. On January 25, CMS released Vaccination Expectations for Surveyors Performing Federal Oversight QSO-22-10-ALL memo. Surveyors who are not fully vaccinated (unless vaccination is medically contraindicated or the individual is legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely held religious beliefs, practices, or observances that conflict with the vaccination requirement) should not participate as part of the onsite survey team performing federal oversight of certified providers and suppliers (including accreditation surveys performed under an AO’s deeming authority). The State Survey Agencies and AOs are ultimately responsible for compliance with this expectation. Therefore, certified providers and suppliers are not permitted to ask surveyors for proof of their vaccination status as a precondition for entry.
CMS updated the long-term care survey documents in accordance with the vaccine mandate. This included updates to the LTC Survey Pathways, Entrance Conference form, and LTCSP Procedure Guide. These items can be found in the surveyor resources zip files under the downloads section of the CMS Nursing Home webpage. Surveyors are instructed to further investigate and potentially give a citation if there is 10% or greater of a difference between the NHSN calculation of vaccinated staff and what the facility provides at the time of survey. A facility is not required to use the new COVID-19 staff vaccination matrix but must provide the list of items in the matrix. The Long-Term Care and Skilled Nursing Facility Attachment A QSO 22-09-ALL document explains how surveyors will determine scope and severity and provides a new scope and severity grid. The level of severity will be cited based on the level of harm, or likelihood of harm for residents. Scope is based on the percent of staff vaccinated because lower vaccination rates are associated with higher numbers of COVID-19 resident cases. Additional details on the vaccine mandate and the surveyor guidance were provided on the LeadingAge Ohio January 26 All-member call. We encourage members to access the webinar slides and recording.
