Federal Register - May 13, 2021
Versione di testo Cosa è?Dateas è un sito indipendente non affiliato a entità governative. La fonte dei documenti PDF che pubblichiamo qui è l'entità governativa indicata in ciascuno di essi. Le versioni in testo sono trascrizioni che realizziamo per facilitare l'accesso e la ricerca di informazioni, ma possono contenere errori o non essere complete.
Source: Federal Register
Federal Register / Vol. 86, No. 91 / Thursday, May 13, 2021 / Rules and Regulations issues related to potential discouragement of visiting volunteers or family members. Instead, we believe that such decisions are best left to each facility, in consideration of CMS and CDC guidance. Our expectation is that vaccination of regular visitors in any of these categories will be encouraged, whether or not the vaccinations are offered by the facility itself.
G. Accounting Statement and Table The Accounting Table summarizes the quantified impact of this rule. It covers only one year because there will likely be many developments regarding
treatments and vaccinations and their effects in future years and we have no way of knowing which will most likely occur. A longer period would be even more speculative than the current estimates.
As explained in various places within the RIA and the preamble as a whole, there are major uncertainties as to the effects of COVID19 on nursing and other congregate living facilities as well as the nation at large. For example, the duration of vaccine effectiveness in preventing infection, reducing disease severity, reducing the risk of death, and preventing disease transmission by
26335
those vaccinated are all currently unknown. These uncertainties also impinge on benefits estimates. For those reasons we have not quantified into annual totals either the life-extending or medical cost-reducing benefits of this rule, and have used only a one-year projection for the cost estimates in our Accounting Statement our estimates are for the last nine months of 2021 and the first three months of 2022. We welcome comments on all of our assumptions and welcome any additional information that would narrow the ranges of uncertainty.
TABLE 7ACCOUNTING STATEMENT: CLASSIFICATION OF ESTIMATED COSTS AND SAVINGS
$ Millions Units Primary estimate
Lower bound
Benefits: Lives Extended not annualized or monetized.
Reduced Medical Expenditures not annualized or monetized.
2020
7
First year.
2020
3
First year.
Costs: Annualized Monetized $ million/
year.
159
119
199
2020
7
First year.
159
119
199
2020
3
First year.
Category
Upper bound Year dollars
Discount rate %
Period covered
Cost Notes: Administrative costs from increased efforts to vaccinate residents and staff.
Transfers
None.
In accordance with the provisions of Executive Order 12866, this regulation was reviewed by the Office of Management and Budget.
I, Elizabeth Richter, Acting Administrator of the Centers for Medicare & Medicaid Services, approved this document on April 22, 2021.
List of Subjects in 42 CFR Part 483
483.80
Grant programs-health, Health facilities, Health professions, Health records, Medicaid, Medicare, Nursing homes, Nutrition, Reporting and recordkeeping requirements, Safety.
For the reasons set forth in the preamble, the Centers for Medicare &
Medicaid Services amends 42 CFR part 483 as set forth below:
PART 483REQUIREMENTS FOR
STATES AND LONG TERM CARE
FACILITIES
1. The authority citation for part 483
continues to read as follows:
Authority: 42 U.S.C. 1302, 1320a7, 1395i, 1395hh and 1396r.
2. Section 483.80 is amended by
VerDate Sep<11>2014
17:44 May 12, 2021
Jkt 253001
a. Revising the heading for paragraph d;
b. Adding paragraph d3;
c. Removing the word and at the end of paragraph g1vii;
d. Revising paragraph g1viii; and e. Adding paragraph g1ix.
The revisions and additions read as follows:
Infection control.
d Influenza, pneumococcal, and COVID19 immunizations
3 COVID19 immunizations. The LTC facility must develop and implement policies and procedures to ensure all the following:
i When COVID19 vaccine is available to the facility, each resident and staff member is offered the COVID
19 vaccine unless the immunization is medically contraindicated or the resident or staff member has already been immunized;
ii Before offering COVID19 vaccine, all staff members are provided with education regarding the benefits and risks and potential side effects associated with the vaccine;
PO 00000
Frm 00031
Fmt 4701
Sfmt 4700
iii Before offering COVID19
vaccine, each resident or the resident representative receives education regarding the benefits and risks and potential side effects associated with the COVID19 vaccine;
iv In situations where COVID19
vaccination requires multiple doses, the resident, resident representative, or staff member is provided with current information regarding those additional doses, including any changes in the benefits or risks and potential side effects associated with the COVID19
vaccine, before requesting consent for administration of any additional doses;
v The resident, resident representative, or staff member has the opportunity to accept or refuse a COVID19 vaccine, and change their decision;
vi The residents medical record includes documentation that indicates, at a minimum, the following:
A That the resident or resident representative was provided education regarding the benefits and potential risks associated with COVID19
vaccine; and B Each dose of COVID19 vaccine administered to the resident; or
E:FRFM13MYR2.SGM
13MYR2
