President Biden speaks about the newly approved COVID-19 vaccine for children

Home healthcare and home care agencies face possible payment denials and termination if they fail to comply with the COVID-19 vaccine mandate announced Thursday by the Centers for Medicare & Medicaid Services. CMS issued that stern warning to participating agencies during a webinar Thursday, hours after it handed down the final rule on the mandate.

“Termination is the absolute last resort and after all other levers have been exhausted,” Lee Fleisher, M.D., chief medical officer at CMS’s Center for Clinical Standards and Quality, said. “It is important to note, however, that we will not  hesitate to use our full enforcement authority to protect the health and safety of patients when our requirements are not met timely.”

The CMS vaccine mandate requires that workers at agencies participating in CMS programs have the first dose of a two-dose vaccine in their arms by Dec. 5. The second dose of the regimen or a one-dose regiment must be completed by Jan. 4, 2022. Home healthcare and home care agencies must also have a process in place that allows employees to request medical or religious exemptions and procedures to track vaccinations.

Katie Smith Sloan, president and CEO of the senior service nonprofit LeadingAge, applauded the rules for helping to protect the lives of seniors and their caregivers. But she also feared the mandate could result in unintended consequences.

“The policy could further complicate staffing issues (including the prospect of additional departures) for our members who are already contending with longstanding workforce challenges exacerbated by the pandemic,” Sloan said in a statement. “We cannot overemphasize the need for staffing support and will continue to make our members’ needs known to the administration and to CMS.”

Charles McDonough, CEO of South Carolina-based Interim HealthCare of the Upstate told McKnight’s Home Care Daily Pulse the mandate will likely sideline some home healthcare workers.

“We do not foresee a max exodus of our workforce. However, we do anticipate that there will be some employees that not only leave our organization, but healthcare all together,” McDonough said.

The Department of Labor’s Occupational Safety and Health Administration also released final rules Thursday for the vaccination mandate affecting businesses with 100 or more workers. Like the CMS order, the OSHA mandate requires workers to get both shots by Jan. 4, 2022. But unlike the CMS rule, the OSHA mandate includes a provision that allows unvaccinated workers to get tested weekly at their own expense.

LHC Group Chairman and CEO Keith Myers told Wall Street analysts during an earnings call Thursday he was pleased the government stepped in with a vaccine mandate because his own firm was considering issuing its own.

“My concern was if we went out and implemented something like this, then we could have employees leaving us and going to other providers who were more lax in this area,” Myers explained. “By leveling the playing field, where it’s either vaccines or tests for everyone, I really do believe this helps us.”

Still, National Association for Home Care & Hospice President William Dombi fears neither mandate levels the playing field for providers.

NAHC remains “concerned that the rules divide home care providers into two categories, those subject to the mandate and those that are not because of size or relationship to Medicare and Medicaid,” Dombi said. “This may lead to staff separations and some access to care limitations. Nonetheless, the home care community remains committed to protecting its patients and staff.”