On October, 26, 2022, CMS released  QSO 23-02 replaces several previous  QSOs and modifies the Scope and Severity of non-compliance. This QSO replaces from QSO 22-07-ALL Revised, QSO 22-09-ALL Revised, and QSO 22-11-ALL Revised. The guidance applies to all states.
 
CMS revised guidance for staff vaccination requirements related to assessing and maintaining compliance with the staff vaccination regulatory requirements.

In the memo, CMS changed the Scope/Severity of citations to reflect the overall improvement in COVID -19 outcomes. It states

Hospitalizations and deaths currently remain relatively low nationwide. This is a testament to the tools and protections in place today, particularly the work that federal, state, local, and private partners have done to get over 226 million people vaccinated and over 111 million boosted. Therefore, CMS is directing that the level of severity and scope for noncompliance at F888 will be cited at severity level 1, with a scope of widespread, or “C.” Noncompliance is based on the failure to implement policies and procedures at 483.80(i)(3)(ii).

It will also recognize the Plan of Correction and Good Faith Effort: Examples include:

• If the facility has no or has limited access to the vaccine, and the facility has documented attempts to obtain vaccine access (e.g., contact with the health department and pharmacies).
• If the facility provides evidence that they have taken aggressive steps to have all staff vaccinated, such as advertising for new staff, hosting vaccine clinics, etc. For example, if the POC demonstrates that the facility staff vaccination rate is 90% or more, and all policies and procedures were developed and implemented, this would be considered a good faith effort and the deficiency could be cleared, with the facility returned to substantial compliance.

Review Appendix A of the memo for complete information. You can find the memo here.