08/21/2025

You Asked... We Answered

You Asked: With the expiration of the Public Health Emergency (PHE) Quality, Safety & Oversight (QSO) memos, and with the flu season coming up, what guidance should nursing homes follow related to vaccinations? 

We Answered: Vaccination requirements for nursing homes are outlined in the State Operations Manual Appendix PP under F883 and F887: 

• §483.80(d)(1) – Influenza: Facilities must offer the influenza vaccine annually (October 1–March 31), provide education on risks/benefits, allow refusal, and document education, administration, or contraindication/refusal in the medical record. 

• §483.80(d)(2) – Pneumococcal: Residents must be offered pneumococcal vaccination with education provided, refusal permitted, and medical record documentation required. 

• §483.80(d)(3) – COVID-19: When available, facilities must offer the vaccine to all residents and staff, provide education on risks/benefits and side effects, document each dose or refusal/contraindication, and maintain staff vaccination records consistent with CDC/NHSN reporting requirements. 

CMS notes that facilities should follow the CDC and ACIP recommendations for vaccines. The information related to current vaccine recommendations, including scheduling and contraindications, may be found on the CDC’s Advisory Committee on Immunization Practices webpage or the “Epidemiology and Prevention of Vaccine-Preventable Diseases,” otherwise known as “The Pink Book”. 

For up-to-date information on indications and timing of pneumococcal vaccines, CMS recommends referring to the following websites:   

• ACIP Vaccine Recommendations and Guidelines 
• Pneumococcal Vaccine Timing for Adults 
• Vaccines & Immunizations