Massachusetts Nursing Homes Influenza Vaccination Update Top 8 Things to Know:
1. All licensed Nursing Homes and Rest Homes’ personnel must be vaccinated against the influenza virus by February 28, 2021.
2. The only reason personnel may be exempt from the vaccine is that administration of the vaccine is medically contraindicated.
3. All licensed healthcare facilities are required to offer a free-of-charge annual influenza vaccine.
4. Facilities are required to document receipt of the vaccine or declination of immunization.
5. Personnel is required to get the vaccine whether or not such individuals provide direct patient care.
6. First data submission is required no later than March 15,2021 and subsequently the 15th of each month.
7. Penalties for failure to cooperate with any document may result in penalties of $50 per day per person.
8. Protecting healthcare personnel and preventing the transmission of influenza to patients and communities is a shared responsibility.
On October 6, 2020, the Commissioner of the Department of Public Health (DPH) issued a public health order (the Order) requiring all licensed Nursing Homes and Rest Homes to ensure that all personnel are vaccinated against influenza virus by December 31, 2020.
Unless such administration is medically contraindicated, which means administration of influenza vaccine is likely to be:
- Detrimental to the individual’s health, or
- Vaccination is against the individual’s religious beliefs (“permissible exemptions”).
- Personnel may not otherwise decline the vaccine.
Due to the Centers for Disease Control and Prevention (CDC) recommendation to avoid other vaccines for 14 days before and after the COVID-19 vaccine is administered, the Order has been modified to require all personnel are vaccinated by February 28, 2021.
As a condition of licensure, under 105 CMR 150.002(D)(8), DPH regulations require all licensed healthcare facilities to:
- Offer, free-of-charge, annual influenza vaccine to all personnel;
- Document receipt of influenza vaccine administered within and outside the facility or document the declination of immunization; and
- Report information to DPH, documenting compliance with the vaccination requirement, in accordance with reporting and data collection guidelines.
To demonstrate compliance, a Nursing Home or Rest Home must meet the reporting requirements described and must comply with any requests for documentation. Failure to comply with the requirements of the Order or failure to cooperate with any document requests with respect to the Order may result in penalties.
The Order defines personnel as an individual or individuals employed by or affiliated with the Nursing Home or Rest Home, whether directly, by contract with another entity, or as an independent contractor, paid or unpaid including, but not limited to, employees, members of the medical staff, contract employees or staff, students, and volunteers who either work at or come to the licensed facility site, whether or not such individual(s) provide direct care.
Personnel requiring the influenza vaccination includes, but is not limited to:
- Physician assistants
- Physical therapists
- Occupational therapists
- Respiratory therapists
- Speech therapists
- Laboratory technicians
- Central supply staff
- Maintenance/environmental services staff
- Dietary staff
- Secretarial and administrative staff
- Contract staff
Personnel is required to get the vaccine whether or not such individuals provide direct patient care. A key component of successful immunization programs includes senior leadership commitment and accountability for outcomes.
The Order requires all Nursing Homes and Rest Homes to provide DPH with their first data submission no later than March 15, 2021, documenting that each member of its personnel has either received the influenza vaccine by December 31, 2020 or declined based upon a permissible exemption. Following that first submission, all Nursing Homes and Rest Homes must provide a final submission on April 15, 2021.
If a facility fails to comply with the Order, including the reporting requirements the healthcare organization will be subject to the following penalties pursuant to G.L. c. 111, § 73 and 105 CMR 153.024(C):
- DPH will impose a penalty of $50 for a failure to report by March 15, 2021.
- DPH will impose a penalty of $50 per day for failure to report data demonstrating compliance with the requirement that each member of its personnel has either received the influenza vaccine by December 31, 2020 or declined based upon a permissible exemption.
- Each member of the facility’s personnel for whom the facility has not submitted the required data is a separate violation.
If the facility is not in compliance with the Order on February 28, 2021, the facility has the period from March 1, 2021 until March 15, 2021 to remedy its noncompliance. For facilities that are not in compliance by March15, 2020, fines will continue to accrue from March 1, 2020 until the facility submits data. A facility may update its data submission at any time, as additional staff receive influenza vaccination.
Subsequent Data Submissions
Each facility must also submit influenza vaccination data on April 15, 2021. The data submission is due on the 15th of each month. DPH will impose a fine of $50 per day for each member of facility personnel who has not received the influenza vaccination.
Annual vaccination is the most important measure to prevent seasonal influenza infection. Protecting healthcare personnel and preventing the transmission of influenza to patients and communities is a shared responsibility.
As of February 23, 2021, the Massachusetts Department of Public Health reported:
- 543,696 confirmed cases of COVID-19 in Massachusetts.
- 15,624 deaths among confirmed cases in the Commonwealth.
- 2.8% death rate.
As of that date, the Massachusetts Department of Public Health reported:
- 34,657 confirmed or probable cases of COVID-19 among residents and staff of long-term care facilities in the Commonwealth.
- 8,524 deaths among those confirmed and probable cases.
- 24.5% death rate.
As of February 23, 2021, across the United States the CDC reported:
- 28,065,327 confirmed cases of COVID-19.
- 501,181 deaths among confirmed cases.
- 1.8% death rate.
As of February 14, 2021, across the United States CMS reported:
- 1,181,826 confirmed cases of COVID-19 among residents and staff of long-term care facilities.
- 129,876 deaths among those confirmed cases.
- 11.0% death rate.
Influenza and COVID-19 present increased risk of severe illness, complications, and death to older adults and particularly those with chronic conditions. Immunization is the most effective method for preventing infection from influenza and possible hospitalization or death. Further, responding to and treating outbreaks of seasonal influenza utilizes many of the same priority resources necessary to respond to cases of COVID-19, including personnel, hospital beds and personal protective equipment.
Click below to download the Massachusetts Department of Public Health Memorandum on Influenza Vaccinations from 12.23.2020.
Harmony Healthcare International (HHI) is hosting our 9th Annual Post-Acute and Long Term Care (PALTC) Interdisciplinary Symposium on Thursday, October 21st, 2021 and Friday, October 22nd, 2021 at the Encore Boston Harbor resort and casino.
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