HHS Secretary Xavier Becerra: All Adults Are Now Eligible for COVID-19 Booster Shots

OSHA Halts Enforcement of Emergency Temporary Standard Vaccine Mandate for Businesses with 100+ Employees

Following a November 12 order from the U.S. Court of Appeals for the 5th Circuit, all activities related to the implementation and enforcement of OSHA’s COVID-19 vaccine Emergency Temporary Standard (ETS) have been suspended.

Litigation has now been transferred to the 6^th Circuit for review following filings in multiple federal circuit courts across the country. Appointment to the 6^th Circuit Court was made by a “lottery” system for purposes of consolidation. It is likely that the case will eventually make its way to the U.S. Supreme Court for final ruling.

Should enforcement of the ETS resume, it is anticipated that OSHA will offer further clarification on medical and religious accommodations.

Readers should note that suspension of the OSHA ETS, which applies to businesses with 100+ employees, does not have any bearing on the CMS “Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule with Comment Period” (IFC). Although there are lawsuits in play against the CMS rules as well, the deadline of January 4^th, 2022 for full-vaccination is still in place.

COVID-19 Health Care Staff Vaccination IFC-6: Presentation Slides and Video

Thank you for your interest in in the COVID-19 Omnibus Vaccine Rule (IFC-6). Thursday’s stakeholder call had a limit of 10,000 participants and we exceeded that number. Please accept our apologies.

CMS has posted the presentation slides and a recording of the stakeholder call for your convenience.

To view the slides, click here.

To view the video, visit: https://www.youtube.com/watch?v=xHA0zY1aC-Y

In addition to the resources above, CMS has prepared a frequently asked questions document, available here:

https://www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.pdf

Hospice Care in Nursing Facilities

Dear Barbara, Can you write about hospice care and the role of the hospice nurse/hospice team in long term care facilities?

The basic premise of hospice is to provide end of life care in the home. Because Assisted Living and/or Nursing Facilities are home for some people, it is appropriate that hospice care be available for residents in these facilities. The issue then becomes is there an overlap of services such as nursing care, bathing, or communication with a physician? Some facilities think there is an overlap and feel they can provide end of life care without the assistance of an outside (hospice) source. Other facilities create their own “hospice” team and provide their own kind of end of life assistance. Still other nursing facilities welcome the expertise of a hospice from outside their facility.

How can Hospice and Nursing Facilities work well together?

I think there are as many ways for a hospice to work with a nursing facility as there are hospices and facilities (all within medicare guidelines of course), but I will tell you what I consider the ideal relationship.

* A hospice team (RN, LPN, SW, HHA, Chaplain, & Volunteers) is assigned to an individual facility. Only that team works in their specific facility. You want everyone in the facility to know, recognize, and understand the hospice team. The entire nursing facility staff (right down to the receptionist) attends an inservice by that hospice team.

* Several educational sessions need to take place in order to clarify not only the role of hospice for the patient, family, attending physician, and facility, but also to provide end of life knowledge (pain management, comfort care, signs of approaching death, and nutritional guidelines) to these same people. Nursing facility regulations are basically in opposition to end of life care. 

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CY 2022 Home Health Final Rule – Survey and Enforcement Requirements for Hospices

To: NHPCO Provider and State Members
From: NHPCO Regulatory Team

Date: November 8, 2021

Summary at a Glance

On November 2, 2021, the Federal Register posted CMS-1747-F, the CY 2022 Home Health Prospective Payment System Rate Update Final Rule… Survey and Enforcement Requirements for Hospice Programs.

Important changes from the proposed to final rule:

1. Suspension of all or part of payments: NHPCO advocated for this provision to be limited to new admissions. In the final rule, CMS changed the language to read that the suspension of payments is for new admissions only.

2. Special Focus Program: NHPCO advocated for a Technical Expert Panel (TEP) to be convened to provide input prior to the development of any hospice Special Focus Program. In the final rule, CMS removed the regulatory language about the creation of the Special Focus Program and cited that revised language would be included in future rule making for FY 2024.

3. Surveyor conflict of interest: NHPCO advocated for ways that CMS could address surveyor conflict of interest. In the final rule, at 488.1110, CMS changed the language on surveyor conflict of interest to read: “surveyors must disclose actual or perceived conflicts of interest prior to participating in a hospice program survey and be provided the opportunity to recuse themselves as necessary.”

CMS has also issued the QSO-22-01-Hospice memo addressing the timeline for implementing the regulatory provisions of the CAA 2021 hospice provisions outlined in the CY 2022 HH final rule.