As you heard yesterday, the CMS vaccine mandate on healthcare workers is now officially back in effect in 26 states following a federal appeals court decision.  The chart at the bottom shows the legal status of the mandate in each state. 

As of this morning, it is unclear if/when enforcement of the Federal vaccine mandate will resume in the 26 states where it is officially back in effect.  CMS’ primary mechanism for enforcing the vaccine mandate is through state survey agencies.  Since CHCs are generally not surveyed by their state agencies, the mandate will be enforced on them via their accreditation surveys – and accrediting organizations adhere to CMS guidance to state survey agencies on these types of issues.

Following the Nov. 30 court decision that blocked the mandate nationally, CMS instructed state survey agencies on December 2 instructing them to not assess providers for compliance with the vaccine mandate “while there are court-ordered injunctions in place prohibiting enforcement of this provision.” 

Now that the court injunction has been lifted in the 26 states, the CMS guidance could be interpreted as requiring state survey agencies (and accrediting organizations) to begin enforcing the mandate.  However, there is disagreement as to whether this is the correct interpretation. 

Given that the Dec. 6 compliance deadline for the Phase One requirements (e.g., all staff having at least one vaccine shot) has passed, we recognize that this creates significant uncertainty for PCAs and CHCs in the 26 states where the mandate is back in effect..  We will monitor the situation closely and share updates as soon as they become available.  (In the meantime, the Federal Vaccine Mandate Toolkit has been updated to reflect this new development.)

Status of CMS COVID vaccine mandate by state, as of 12/15/2021