LeadingAge had a small call with CMS on Tuesday. A few notes, below:

• RoPs 3 guidance – still no timeline for when this guidance might be released. Recall that RoPs 3 went into effect in November 2019 but surveyor guidance has yet to be released. CMS continues to work on this in the midst of COVID-19 and COVID-related guidance.
• Visitation and other guidance – COVID-19 guidance such as visitation, testing, cohorting, PPE use, etc. is not being updated at this time, despite growing rates of vaccination in nursing homes. Recall as we noted last week that transmissibility remains a concern. The vaccines’ effectiveness against transmissibility is being evaluated, but in order to get good data, we need more people to be vaccinated. We hear a lot: “Why get vaccinated if it won’t make a difference?” It does make a difference. You just have to focus on the right measures. If more people get vaccinated, fewer people will get sick. This means lower community rates, which means fewer outbreaks in nursing homes and lower county positivity rates. That directly translates to less testing, more indoor visitation, more group activities, dining and more. So keep your eyes on the prize, your mouth and nose covered by a mask, and help get those vaccines in arms!
• Residents rights and vaccines – Now that vaccination is becoming more wide-spread in nursing homes and other settings, it’s bringing up new questions: How do we handle requests that residents be cared for by vaccinated staff only? Room with vaccinated roommates only? Can a facility deny admission based on vaccination status? Can a facility cohort based on vaccination status? Remember this: an individual’s vaccination status is protected health information, so residents and families don’t have the right to know which residents or staff have been vaccinated. Likewise, staff may not necessarily have the right to know whether or not a resident has been vaccinated. Further specifics below:
  • Requests to be cared for by vaccinated staff only: These requests should be handled like any other staffing request. Residents have the right to request specific staff, nursing homes should consider and accommodate requests as able, but are not required to accommodate requests. CMS expects that all staff will provide safe care regardless of vaccination status.
  • Requests to room with vaccinated roommates only: These requests should be handled like any other room change request. Residents have the right to request a room change, nursing homes should consider and accommodate requests as able, but are not required to accommodate requests.
  • Cohorting according to vaccination status: CMS notes that it may be in a facility’s best interest to cohort according to vaccination status; however, there is no requirement to cohort and no requirement prohibiting cohorting. But be careful not to cross the line from health and safety measures into discrimination and resident rights violations.
  • Vaccination status impact on admission: Admission cannot be denied solely on the basis of vaccination status or vaccine hesitancy.

Questions?

Contact: 

Laura Hofmann, MSN, RN – Director of Clinical and Nursing Facility Regulatory Services
c: 425-231-4804