Nursing homes in Kansas run the risk of losing their federal funding, following Gov. Laura Kelly’s call to deter enforcement of the COVID-19 vaccine mandate.
The Centers for Medicare and Medicaid Services (CMS) shared its plans in a letter dated March 18 to reduce survey and certification funding by $348,723 for this year if the state continues with its new rule, in order to “implement supplemental federal processes to ensure provider compliance.”
State surveyors will not be enforcing the federal mandate at health care provider facilities, Kelly said on Tuesday, citing a worry the mandate will “further intensify” the industry’s workforce shortage.
“Kansas employees should not be required to enforce a federal mandate this late in the pandemic,” Kelly added in a statement first reported by the Kansas City Star.
Kansas was one of 25 states involved in legal challenges to the CMS mandate last year, which were ultimately blocked by the Supreme Court. Federal court-issued injunctions in Missouri, Louisiana and Texas were all appealed by CMS until the high court decision.
The state even added a budget provision last year prohibiting surveyors from using state funding to implement the vaccine mandate, a caveat likely to carry over to enforcement.
CMS originally issued its mandate only for nursing home workers in August of last year, before the agency expanded its rule to include any health provider that receives Medicare or Medicaid funding.
Kelly met with Health and Human Services (HHS) Secretary Xavier Becerra in late January to discuss potential repercussions of the mandate on Kansas health care providers, including nursing homes, local reports said.
“CMS leadership has assured me they’re working with facilities and will not take punitive measures,” Kelly said.
The agency’s letter to the state was less reassuring. CMS Principal Deputy Administrator and COO Jonathan Blum told state officials that providers are still responsible for complying with federal requirements in order to participate in the Medicaid and Medicare programs, “despite the state’s announcement.”
About 1,120 health care providers, including nursing homes, fall under the vaccine mandate, CMS said.
Agency-approved accrediting organizations will continue to survey for compliance with Medicare and Medicaid regulations – including the vaccine mandate.
“We are not waiving any terms and continue to expect full performance of Kansas’ obligations under the law and pursuant to the agreement,” Blum said.
A shift from state surveyors to federal surveyors comes at a price, Blum said.
The agency will incur additional costs as a result of the new Kansas rule, Blum said in the letter, and will in turn reduce state budget allocation to compensate for that loss.
Kansas usually gets about $6.5 million in CMS funding every year for survey work, according to a Topeka Capital-Journal report.
Kansas has the eighth-lowest staff vaccination rate among nursing homes at 79.59%, based on data published by CMS. The state is more middle of the pack if boosters are included, coming in ahead of 17 other states.
About 71 active Covid outbreaks in Kansas nursing homes and other long-term care facilities were linked to 1,437 cases, 26 hospitalizations and 29 deaths, according to a report issued by the state Department of Health and Environment (KDHE).
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