Health-Care Staff Vaccination Requirements

In late December 2021, the Centers for Medicare and Medicaid Services (CMS) released guidance on the Health Care Staff Vaccination Interim Final Rule. The emergency regulation requires vaccinations for eligible staff at health care facilities participating in the Medicare and Medicaid programs.

Where It Applies

The staff vaccination requirement applies to the following Medicare and Medicaid-certified provider and supplier types:

• Ambulatory Surgery Centers
• Community Mental Health Centers
• Comprehensive Outpatient Rehabilitation Facilities
• Critical Access Hospitals
• End-Stage Renal Disease Facilities
• Home Health Agencies
• Home Infusion Therapy Suppliers
• Hospices
• Hospitals
• Intermediate Care Facilities for Individuals with Intellectual Disabilities
• Clinics
• Rehabilitation Agencies
• Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services
• Psychiatric Residential Treatment Facilities (PRTFs) Programs for All-Inclusive Care for the Elderly Organizations (PACE)
• Rural Health Clinics/Medicare Federally Qualified Health Centers
• Long Term Care facilities

Implementation and Enforcement by State

Per CMS, implementation and enforcement of this regulation does NOT apply to the following States at this time: 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, Texas, Utah, West Virginia, and Wyoming.

Facilities in these states are not required to comply with the rule, pending future developments in litigation. 

The rule applies to facilities participating in the Medicare and Medicaid programs in the remaining 25 states, the District of Columbia, and the territories.

What Must Be Done

Facilities covered by this regulation must establish a policy ensuring all eligible staff have received the first dose of a two-dose COVID-19 vaccine or a one-dose COVID-19 vaccine prior to providing any care, treatment, or other services by January 27, 2022—30 days following the publication of the guidance. 

All eligible staff must have received the necessary shots to be fully vaccinated—either two doses of Pfizer or Moderna or one dose of Johnson & Johnson—by February 28, 2022—60 days following the publication of the guidance.

IMPORTANT

This is an area of evolving regulation and litigation. Currently, the Supreme Court is hearing arguments. The Academy will publish updated information as it is available.

CMS Resources

• CMS December 28, 2021 Memorandum to the States
• CMS Resource Portal—Interim Final Rule Guidance
• CMS FAQs