DOH Issues Emergency Regulations on Nursing Home and ACF Resident and Staff Vaccinations
On April 15th, the Department of Health (DOH) issued emergency regulations requiring nursing homes and adult care facilities (ACFs) to ensure access to vaccination for residents and staff. DOH has since issued Dear Administrator Letters (DALs) to nursing homes and ACFs alerting them to the regulations.
Specifically, ACFs must, within seven days (by April 22nd), make diligent efforts to schedule vaccine appointments for consenting residents and staff, including contract staff. This includes accessing second doses of vaccine if needed. For new residents, readmissions, and staff, ACFs must make efforts to schedule vaccine appointments within seven days of having been admitted, readmitted, or hired. DOH directs ACFs to develop processes and procedures to ensure compliance.
Nursing homes must, within 14 days (by April 29th), offer all consenting, unvaccinated existing staff, including contract staff, and residents an opportunity to receive the first or any required next dose of the COVID-19 vaccine. For new residents, readmissions, and staff, nursing homes must offer the vaccine within 14 days of having been admitted, readmitted, or hired. In addition, nursing homes must post conspicuous signage throughout the facility, including at points of entry and exit and each residential hallway, reminding personnel and residents that the facility offers COVID-19 vaccination.
Both ACFs and nursing homes must maintain documentation of all personnel and residents who decline to be vaccinated which indicates that they were offered the opportunity for a COVID-19 vaccination but declined, and that they are aware that if they later decide to be vaccinated for COVID-19, it is their responsibility to request vaccination from the facility. The Department has not provided a template for this declination form. We advise that you adopt the language in the regulation in developing your own. Please note that we interpret the regulations to require you to discuss vaccination with current staff who had previously declined and either facilitate access to vaccination or have them sign the declination form as appropriate.
Both ACFs and nursing homes should be sure to document all efforts to ensure access to the vaccine, particularly if you are having difficulty obtaining access for logistical reasons.
DOH will require certification of compliance with these requirements on a weekly basis, beginning April 29th. Penalties can be levied for failure to comply.
We understand that while members share the goal of getting as many consenting residents and staff vaccinated as quickly as possible, there are some real logistical concerns that are creating barriers to compliance with the regulations as framed. We have been conveying these challenges to DOH for months now and will continue to try and work to address these issues. Please keep us informed of your challenges and let us know your questions.