All States, Territories Now Subject to CMS COVID-19 Vaccination Rule
By A.J. Plunkett
All U.S. states and territories are now subject to the CMS interim final rule requiring staff to be fully vaccinated against COVID-19.
In a new memo to CMS state surveyors posted January 20, the agency added Texas as the final state subject to the rule after the last injunction was lifted from court challenges filed last year to the federal mandate.
The deadlines for having all staff vaccinated vary according to the version of the memo under which your state falls.
The first memo, which also outlined how the mandate was going to be surveyed and enforced, was published on December 28 and covered the 25 states and territories not subject to the injunctions.
The second memo was published January 14, following a Supreme Court decision lifting the injunction. CMS said it would enforce the vaccine mandate in all the other states, except Texas, which had a separate court challenge.
Soon after, The Joint Commission issued a statement noting that it was enforcing the mandate, per CMS instructions. DNV Healthcare, the Accreditation Commission for Health Care/HFAP, and the Center for Improvement in Healthcare Quality have all indicated they are also following CMS’ lead.
The third CMS memo was published January 20 and included Texas after the separate court challenge was effectively dropped.
The three CMS memos are all essentially the same, the difference being which states or territories were subject to enforcement. The memos stated that the deadlines for when staff were expected to be at least partially and then fully vaccinated were 30 and 60 days, respectively, from the publication of the memos.
The mandate is for healthcare facilities where providers treat or may treat patients with COVID-19, such as but not limited to hospitals, long-term care facilities and hospices.
So what does that mean for your facility?
The deadline for all staff to have at least one shot of vaccine or be granted an accepted exemption is January 27 if you are in:
- California
- Colorado
- Connecticut
- Delaware
- Florida
- Hawaii
- Illinois
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Nevada
- New Jersey
- New Mexico
- New York
- North Carolina
- Oregon
- Pennsylvania
- Rhode Island
- Tennessee
- Vermont
- Virginia
- Washington
- Wisconsin
- The District of Columbia
- All other U.S. territories and tribal communities
All staff who received the Pfizer or Moderna vaccines must have their second vaccine shot by February 28, which is the Monday after the 60-day deadline, which falls on a Saturday. Staff with the single shot of Johnson & Johnson are of course considered fully vaccinated by then anyway.
Deadlines are February 14 (the Monday after the 30-day period) and March 15 for facilities in:
- Alabama
- Alaska
- Arizona
- Arkansas
- Georgia
- Idaho
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Mississippi
- Missouri
- Montana
- Nebraska
- New Hampshire
- North Dakota
- Ohio
- Oklahoma
- South Carolina
- South Dakota
- Utah
- West Virginia
- Wyoming
If your facility is in Texas, your deadlines are February 21 (the Monday after the 30-day deadline) and March 21.
Facilities who have cannot meet the 100% vaccination or exemption requirement for each of those deadlines but has a significant plan in progress to get to 100% will not face the penalties immediately, which could include civil fines for some facilities and termination from Medicare and Medicare participation for hospitals and other facilities.
CMS and the accrediting organizations have said they will work with those facilities.
Each of the memos has an appendix outlining the survey procedures and specifics for each provider type. For hospitals, go to https://www.cms.gov/files/document/attachment-d-hospital.pdf-0.