LeadingAge National Advocates for Members on CMS Vaccination Rule

Posted on July 14, 2021 by Jonathan Lips

On behalf of members across the country, the LeadingAge national team has submitted comments to CMS on the recently-issued rule requiring nursing homes to offer COVID-19 vaccine to residents and staff, to educate residents and staff regarding the benefits and potential side effects of the vaccine, and to report COVID-19 vaccine and therapeutics treatment information to NSHN.

LeadingAge submitted two comment letters, one directed to the rule’s requirements for nursing homes, which are already in effect, and a separate letter addressing specific questions where CMS asked for input relating to assisted living and home and community-based services.

Highlights of LeadingAge’s comments on the nursing home provisions include:

• To address vagueness in the provision requiring education about COVID vaccinations, LeadingAge urges CMS to state a clear, minimum standard for compliance with the requirement, such as providing the emergency use authorization (EUA) fact sheet to residents and staff.
• Noting some mixed messaging about "how much is enough" when it comes to offering vaccination to those who so far have decided not to get it, LeadingAge recommend that CMS develop a framework available to both surveyors and providers to help determine sufficient education on and offering of COVID-19 vaccination to residents and staff.
• The letter notes the significant time burden of submitting data and asks CMS and CDC to reconsider and reduce the reporting requirements, including requiring data only for direct care staff and making alternative reporting methods available, such as through the MDS or the Payroll Based Journal.
• And concerning the punitive enforcement system, LeadingAge asks CMS not to impose fines at all (and to withdraw fines already issued) for a certain period and, from now on, to create a process by which providers have an opportunity to correct missing or erroneous data before citations and penalties are issued.

When CMS published the rule, it asked for feedback to inform future federal programming and policy decisions. Specifically, it asked for input regarding ensuring equitable distribution of vaccines to participants and staff home and community-based programs and whether vaccination reporting should be mandatory for assisted living and ICF/DD providers. 

The LeadingAge letter addressing these questions recommends developing additional federal partnerships and programs to address vaccine access for HCBS workers and recipients. They propose that center-based providers would have the option to host onsite vaccine clinics for any workers or recipients who have not yet been vaccinated. Additionally, LeadingAge asks that any future prioritization effort should come with a requirement that HCBS workers be given the same priority as other health care workers, including nursing home and hospital staff.

LeadingAge also argues that the requirements should not be mandatory for assisted living providers, noting "the requirements are overly burdensome on AL providers, they are duplicative of the many state educational and reporting requirements imposed on AL providers, and CMS lacks the regulatory or oversight authority over AL providers (especially those that do not participate in a state Medicaid waiver program)."

CMS will take all public comments into account and announce any adjustments to the rule later this year.