Document ID: ./input/supremecourt_opinions/opinions/21pdf/21a240_d18e.pdf
Page Number: 3.0

Cite as:  595 U. S. ____ (2022) 

3 

Per Curiam 

(long-term care facilities); see, e.g., §§482.42(a) (hospitals),
416.51(b) (ambulatory surgical centers), 485.725 (facilities
that  provide  outpatient  physical  therapy  and  speech-lan-
guage pathology services). 

B 

On  November  5,  2021,  the  Secretary  issued  an  interim 
final rule amending the existing conditions of participation 
in Medicare and Medicaid to add a new requirement—that 
facilities  ensure  that  their  covered  staff  are  vaccinated 
against COVID–19.  86 Fed. Reg. 61561, 61616–61627.  The 
rule  requires  providers  to  offer  medical  and  religious  ex-
emptions, and does not cover staff who telework full-time. 
Id., at 61571–61572.  A facility’s failure to comply may lead 
to  monetary  penalties,  denial  of  payment  for  new  admis-
sions,  and  ultimately  termination  of  participation  in  the 
programs.  Id., at 61574. 

The Secretary issued the rule after finding that vaccina-
tion of healthcare workers against COVID–19 was “neces-
sary for the health and safety of individuals to whom care
and services are furnished.”  Id., at 61561.  In many facili-
ties,  35%  or  more  of  staff  remain  unvaccinated,  id.,  at 
61559, and those staff, the Secretary explained, pose a seri-
ous threat to the health and safety of patients.  That deter-
mination  was  based  on  data  showing  that  the  COVID–19
virus  can  spread  rapidly  among  healthcare  workers  and 
from them to patients, and that such spread is more likely 
when healthcare workers are unvaccinated.  Id., at 61558– 
61561, 61567–61568, 61585–61586.  He also explained that,
because Medicare and Medicaid patients are often elderly,
disabled,  or  otherwise  in  poor  health,  transmission  of 
COVID–19 to such patients is particularly dangerous.  Id., 
at  61566,  61609.    In  addition  to  the  threat  posed  by  in-
facility  transmission  itself,  the  Secretary  also  found  that 
“fear  of  exposure”  to  the  virus  “from  unvaccinated  health
care  staff  can  lead  patients  to  themselves  forgo  seeking