Centers for Medicare & Medicaid Services (CMS) released a final rule in the Federal Register on May 31 that terminates the COVID-19 vaccination mandate for staff in CMS-certified settings. The rule includes additional provisions for nursing homes, finalizing components of the interim final rule published in May 2021 that requires nursing homes to educate residents and staff on COVID-19 vaccination and offer or assist with accessing vaccination. The rule also terminates requirements related to COVID-19 testing in nursing homes, though nursing homes will still be required to conduct testing according to recommendations from the Centers for Disease Control & Prevention (CDC) as part of the accepted national standards with which nursing homes must comply under requirements at 42 CFR §483.80 Infection Control. This rule goes into effect 60 days from the date of publication in the Federal Register, which is currently scheduled for June 5.

COVID-19 Vaccination Mandate

In November 2021, CMS issued interim final rule Omnibus COVID-19 Health Care Staff Vaccination that required development and implementation of policies and procedures in most CMS-certified settings to ensure COVID-19 vaccination of staff. CMS now states that “the risks targeted by the staff vaccination IFC [interim final rule with comment period] have been largely addressed, so we are now aligning our approach with those for other infectious diseases, specifically influenza.” CMS is terminating the staff vaccine mandate and will instead support and encourage COVID-19 vaccination of healthcare workers through quality reporting and value-based incentive programs. The rule goes into effect in August, but CMS has stated that they will not be enforcing staff vaccination provisions between now and the effective termination date. LeadingAge members should check with their states to ensure continued compliance with any applicable state requirements and recall that reporting of vaccination status of nursing home staff and residents through the National Healthcare Safety Network (NHSN) system will continue.

“Educate and Offer” Requirements for Long-Term Care Settings

In May 2021, CMS issued interim final rule COVID-19 Vaccine Requirements for Long-Term Care Facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities, Residents, Clients, and Staff that required these settings to provide education on and offer COVID-19 vaccination to residents/clients and staff. Due to the nature of interim final rules, these requirements would remain in effect until May 2024 unless further action was taken by CMS. With the final rule released on May 31, 2023, CMS is finalizing these requirements indefinitely. Long-term care settings must continue to educate and offer COVID-19 vaccination to residents and staff as part of the Requirements of Participation. LeadingAge encourages nursing home members to review efforts to educate and offer COVID-19 vaccination up to this point, as well as education and offering strategies for other vaccinations such as influenza and pneumococcal to identify any missing components and opportunities to streamline to ensure compliance with all requirements.

COVID-19 Testing for Long-Term Care Settings

In September 2020, CMS issued interim final rule outlining COVID-19 testing requirements for long-term care settings. The rule stated that requirements would expire with the end of the public health emergency. The public health emergency ended on May 11, 2023 and CMS has taken regulatory action to remove the expired language from the Requirements of Participation. LeadingAge encourages nursing home members to review CDC recommendations for infection prevention and control to ensure proper testing and mitigation strategies in accordance with accepted national standards under §483.80 Infection Control of the Requirements of Participation.