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This attachment is a supplement to existing memoranda and provides guidance for all states on the requirements for COVID-19 vaccination for staff of long-term care and skilled nursing facilities. This guidance applies to all facility staff who provide any care, treatment, or other services for the facility and/or its residents, including employees, licensed practitioners, adult students, trainees, and volunteers, as well as individuals who provide care, treatment, or other services for the facility and/or its residents, under contract or by other arrangements. Facilities must develop and implement policies and procedures to ensure that all staff are fully vaccinated for COVID-19, and these policies and procedures must include a process for ensuring all staff have received the primary vaccination series, a process for tracking and securely documenting the COVID-19 vaccination status of all staff, a process for tracking and securely documenting the COVID-19 vaccination status of any staff who have obtained any booster doses, a process by which staff may request an exemption from the staff COVID-19 vaccination requirements, and a process for ensuring the tracking and secure documentation of the vaccination status of staff for whom COVID-19 vaccination must be temporarily delayed. Surveyors will begin surveying facilities for compliance 30 days from the date of issuance of the applicable memorandum. Nursing homes must take action to ensure that all staff are fully vaccinated for COVID-19 in accordance with the guidance outlined in this attachment.

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