See HHS OIG reports OEI-09-21-00140 and OEI-06-20-00300, both accessed September 26, 2021. Section 1861(e) of the Act provides that hospitals participating in Medicare and Medicaid must meet certain specified requirements, and the Secretary may impose additional requirements if they are found necessary in the interest of the health and safety of the individuals who are furnished services in hospitals. According to Table 3, CMHCs have 140,000 employees. The surgical services performed in ASCs generally are scheduled, non-life-threatening procedures that can be safely performed in either a hospital setting (inpatient or outpatient) or in an ASC. They are powerful tools that can project a positive image of your company, Electronic Thus, for each CMHC, the burden for the administrator would be 8 hours at a cost of $904 (8 113). Document Drafting Handbook Hence, we are revising 485.58(d)(4) to state that personnel that do not meet the qualifications specified in 485.70(a) through (m) may be used by the facility in assisting qualified staff. Q. L. 96-354), section 1102(b) of the Social Security Act, section 202 of the Amend 485.58 by revising paragraph (d)(4) to read as follows: (4) The services must be furnished by personnel that meet the qualifications of 485.70 and the number of qualified personnel must be adequate for the volume and diversity of services offered. LTC facility staff vaccination rates range from lows of 56 percent to highs of over 90 percent, depending upon the State. This second IFC contained additional information on changes Medicare made to existing regulations to provide flexibilities for Medicare beneficiaries and providers to respond effectively to the PHE for COVID-19. The study further expects that reductions in life expectancy may persist because of continued COVID-19 mortality and term health, social, and economic impacts of the pandemic. ESRD networks also provide education on patient influenza and pneumococcal vaccinations as a part of their work and also recently (in 2020) added a goal of 85 percent of patients vaccinated for flu while also encouraging vaccinations for staff within ESRD facilities. https://www.npr.org/sections/health-shots/2021/10/14/1043414558/with-hospitals-crowded-from-covid-1-in-5-american-families-delays-health-care. 130. While provider and supplier staff may not have personal medical records on file with their employer, all staff COVID-19 vaccines must be appropriately documented by the provider or supplier. The effective delivery of quality home health services is essential to the care of the HHA's patients to provide necessary care and services and prevent hospitalizations. Hence, we believe activities associated with this IFC would be performed by the administrator as analyzed below. have already received information about the benefits and safety of COVID-19 vaccination, and the rare serious risks associated with it. Researchers have noted that the number of hours spent playing videogames is not necessarily a core indicator of addiction. 25262728293031Start Printed Page 61558 On the other hand, staff members' own risk raises the question of how to interpret their hesitation or unwillingness, in the absence of regulation, to accept an intervention that achieves extensive health protection for themselves, with little or no out-of-pocket cost, and ever-lessening time or inconvenience cost; a simplistic revealed-preference monetization of the rule's effect would be that it yields minimal or negative benefits for such staff members, even the ones for whom it prevents or reduces severity of COVID-19 infection. Ashvin Gandhi Therefore, the total burden for all 141 PACE organizations for this rule would be 2,243 (1,410 + 833) hours at an estimated cost of $179,518 (117,876 + 61,642). This includes workers moving between various types of providers, such as from LTC facilities to HHAs and others, creating imbalances. The administrator would conduct research to either modify or develop policies and procedures. Another unknown is what currently unvaccinated employees would do when the vaccination deadline is reached, and how rapidly those quitting rather than being vaccinated could be replaced. For each sentence or dialogue there are four choices marked A, B, C and D. Choose the best one to complete the following sentences. Section 416.51(c) also requires ASCs to track and securely maintain the required documentation of staff COVID-19 vaccination status. The Federal Medicaid program does not reimburse states for the cost of covered services provided to beneficiaries in institutions for mental diseases (IMDs) except in specific, statutorily-authorized exceptions, including for young people who receive this service, and individuals age 65 or older served in an IMD. Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler) Rich Dad, Poor Dad (Robert T. Kiyosaki) Civilization and its Discontents (Sigmund Freud) Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham) Psychology (David G. Myers; C. Nathan DeWall) Interpersonal Communication (Kory Floyd) Annuals of Internal Medicine. Justin Michael Katy, and Patricia have been assigned to Workgroup C The presentation noted that the company had sold more than 450000 widots last year The report appendices, including those that chart revenue gains for the past two years, can be found in the back pocket of your folder Since the embezzlement scandal, the CFO has had a sout look on his face LinoPrint Inc. would Be to hire an additional printmaker but the cost is prohibitive. Thus, unless otherwise indicated, all of the numbers for the providers and suppliers in this analysis were located on September 1, 2021 on the Quality, Certification & Oversight Reports (QCOR) website at [98] Start Printed Page 61572 Accessed 10/14/2021. We believe these activities would be performed by the RN and an administrator. of this IFC, we are adding a new regulatory requirement at 418.60(d) related to establishing and implementing policies and procedures for COVID-19 vaccination of all staff (including employees; licensed practitioner; students, trainees, and volunteers; and other individuals) who provide care, treatment, or other services for the provider or its patients. We also estimate that vaccination reduces the chance of infection by about 95 percent, and the risk of death from the virus to a fraction of 1 percent. Accessed 10/17/2021. (ii) Staff who provide support services for the PACE organization and/or its participants and who do not have any direct contact with participants and other PACE organization staff specified in paragraph (d)(1) of this section. For example, a plumber who makes an emergency repair in an empty restroom or service area and correctly wears a mask for the entirety of the visit may not be an appropriate candidate for mandatory vaccination. Exempting previously infected individuals would have potentially reduced benefits while reducing costs, both roughly in proportion to the number affected. Life-saving benefits to employees would be about $5,300,000 ($10,600,000 VSL 100 .005) for 100 people assuming that the death rate for these far younger 100 people is 1 in 500 hundred. 48. Another option would be to devise a standard with graduated compliance expectations such as 90 percent and then 95 percent and then 100 percent of staff vaccinated and a time period in which to reach each level. Based on current CDC guidance,[95] The total costs used in this analysis are indicated in Table 3. answer choices My friend, Aaron, sat in the bleachers and is cheering for our team. [214] Explanation: Despite emergency expansion of critical care units, these waves of severely ill patients have overwhelmed hospitals, health care systems, and the professionals and other staff who work in them. Standard: COVID-19 vaccination of organization staff. The administrator and mental health clinician would need to make the necessary revisions and draft any necessary policies and procedures. The population of older adults, and LTC facility residents in particular, have been hard hit by the impacts of the pandemic. [135] For those same reasons, as authorized by the Small Business Regulatory Enforcement Fairness Act of 1996 (the Congressional Review Act or CRA), 5 U.S.C. Thus, all hospices should already have infection prevention and control policies and procedures, but they likely do not comply with all of the requirements in this IFC. We believe that this would require an administrator 5 minutes or 0.0833 hours to perform the required documentation at adjusted hourly wage of $113 for each employee. press@cms.hhs.gov. We believe these activities would be performed by the IP, the director of nursing (DON), and an administrator. 174. We believe the burden for the documentation requirements in this rule should be included in that burden. 42 U.S.C. Explanation: 154. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/disparities-hospitalization.html. As discussed above, the revision and approval of these policies and procedures would also require activities by the administrator. Points: Routine Messages: E-mails, Memos, and Letters. Explanation: effective for preventing infection, and especially severe illness and death [and] reduce the risk of spreading the virus.[126] Points: Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services, 3. [247] 1 / 1. CMS continues to encourage individuals not to submit duplicative comments. See for example Jiangzhuo Chen et al, Medical costs of keeping the US economy open during COVID-19, Scientific Reports, Nature.com, July 19 2020, at The largest part of those costs is for hospitalization. Since the onset of the PHE, we have issued five IFCs to help contain the spread of SARS-CoV-2. Get it corrected in a few minutes by our editors. https://www.cdc.gov/mmwr/volumes/70/wr/mm7030a2.htm. For example, expedient evacuation of a flooding LTC facility may require assistance from local community members of unknown vaccination status. Data from CDC's National Healthcare Safety Network (NHSN) have shown that case rates among LTC facility residents are higher in facilities with lower vaccination coverage among staff; specifically, residents of LTC facilities in which vaccination coverage of staff is 75 percent or lower experience higher crude rates of preventable SARS-CoV-2 infection. For the administrators in all 6,071 ASCs, the burden would be 12,142 hours (2 6,071) at an estimated cost of $1,189,916 ($196 6,071). Chevalier, and Elisa F. Long, Nursing home staff networks and COVID-19, PNAS, January 5, 2021, at accessed 10/18/2021. Improving Tone and Clarity The clarity and tone of a message are improved when you use positive and courteous language. According to Table 3, an RN's total hourly cost is $74. Potter J, Stott DJ, Roberts MA, et al. Standard: COVID-19 Vaccination of Home Health Agency staff. Of these, the great majority were in the year 2020. ** Italic. Why if you did not want to hear it did you ask me what I thought 60. Specifically, sections 1102 and 1871 of the Social Security Act (the Act) grant the Secretary of Health and Human Services authority to make and publish such rules and regulations, not inconsistent with the Act, as may be necessary to the efficient administration of the functions with which the Secretary is charged under this Act and as may be necessary to carry out the administration of the insurance programs under the Act. It is expected that the new schedule will be announced by the bus company within the next few days. Choose the best revision for the following sentences. Providers and suppliers may be covered by both the OSHA ETS and our interim final rule. A retrospective analysis from England found up to 1 in 6 SARS-CoV-2 infections among hospitalized patients with COVID-19 in England during the first 6 months of the pandemic could be attributed to healthcare-associated transmission. In Table 5 we provide a rough estimate of the likely number of full-time employees and other employees and contractors subject to this rule. Let me explain our policy regarding warranties. ) Assuming that the average life expectancy of long term care residents is 5 years, the monetized benefits of saving one statistical life would be about $3.0 million ($590,000 x annually for 5 years) at a 3 percent discount rate and about $4.8 million ($970,000 x annually for 5 years) at a 7 percent discount rate. 79. The facility must develop and implement policies and procedures to ensure that all staff are fully vaccinated for COVID-19. Thank you for bringing this error to our https://doi.org/10.2215/CJN.12360720 Current regulations at 483.80(d)(1) and (2) already require LTC facilities to have policies and procedures to educate, offer, and document vaccination status for residents regarding the influenza and pneumococcal immunizations. Choose the best revision for the following sentences: Joel went to sleep early he wasn't tired he wanted to get an early start the next day 1 See answer Advertisement mcarc09 Among the answer choices, the best revision is " Although he wasn't tired, Joel went to sleep early because he wanted to get an early.", thus option B. Hence, a requirement for these staff to receive COVID-19 vaccination is necessary to assure health and safety for the individuals residing in their respective service areas and their patients. For purposes of estimation, we assume that, on average, one hour of staff time or the equivalent will be devoted to counseling or incentives for each unvaccinated staff person, at the same average hourly cost of about $75 estimated for RNs in the Information Collection analysis. A. project managers B. project directors Current regulations at 485.725(a) require organizations to establish an infection-control committee of representative professional staff with overall responsibility for infection control. Proceedings of the National Academy of Sciences of the United States of America, 118(5), e2014746118. Effectiveness of the Pfizer-BioNTech COVID-19 Vaccine Among Residents of Two Skilled Nursing Facilities Experiencing COVID-19 OutbreaksConnecticut, December 2020-February 2021. March 19, 2021. By regular mail. Weegy: The connective is "however". Report of Nationally Representative Values for the Noninstitutionalized US Adult Population for 7 Health-Related Quality-of-Life Scores. They're the best! (i) Staff who exclusively provide telehealth or telemedicine services outside of the facility setting and who do not have any direct contact with residents and other staff specified in paragraph (i)(1) of this section; and. We recognize this sentence is inconsistent with newly added 485.70(n) which requires vaccination of all facility staff. Please allow sufficient time for mailed comments to be received before the close of the comment period. FDA analysis has shown that all of the currently approved or authorized vaccines are safe and CDC reports that over 408 million doses of the vaccine have been given through October 18, 2021. In addition, the patients' homes may have poor ventilation or members of the household may not be complying with recommended safety precautions. Start Printed Page 61579 Home Infusion Therapy Suppliers (HIT) Suppliers, 4. 11/04/2021 at 8:45 am. CMS has broad statutory authority to establish health and safety regulations, which includes authority to establish vaccination requirements. Licensed is the statutory term under section 351 of the Public Health Service Act for what is commonly referred to as approval of a biological product. The requirements and burden will be submitted to OMB under OMB control number 0938-0334 (expiration date March 31, 2023). Nonetheless, there are two major arguments against such a system in the context of this rule. (i) A process for ensuring all staff specified in paragraph (c)(1) of this section (except for those staff who have pending requests for, or who have been granted, exemptions to the vaccination requirements of this section, or those staff for whom COVID-19 vaccination must be temporarily delayed, as recommended by the CDC, due to clinical precautions and considerations) have received, at a minimum, a single-dose COVID-19 vaccine, or the first dose of the primary vaccination series for a multi-dose COVID-19 vaccine prior to staff providing any care, treatment, or other services for the qualified home infusion therapy supplier and/or its patients; (vii) A process for tracking and securely documenting information provided by those staff who have requested, and for whom the qualified home infusion therapy supplier has granted, an exemption from the staff COVID-19 vaccination requirements; (viii) A process for ensuring that all documentation, which confirms recognized clinical contraindications to COVID-19 vaccines and which supports staff requests for medical exemptions from vaccination, has been signed and dated by a licensed practitioner, who is not the individual requesting the exemption, and who is acting within their respective scope of practice as defined by, and in accordance with, all applicable State and local laws, and for further ensuring that such documentation contains; (B) A statement by the authenticating practitioner recommending that the staff member be exempted from the qualified home infusion therapy supplier's COVID-19 vaccination requirements for staff based on the recognized clinical contraindications; 25. At 483.80(i), we require LTC facilities to develop and implement policies and procedures to ensure their staff are vaccinated for COVID-19 and that appropriate documentation of those vaccinations are tracked and maintained. https://news.christianacare.org/2021/09/safe-care-safe-workplace-we-are-vaccinated/. Read her letter and look for any revisions she should make. (50-75 words) - Confidence - Awareness - Brave Confidence - It is important for a leader because he must believe in himself and that his actions will in fact be the right ones. PRTFs are non-hospital facilities that provide inpatient psychiatric services to Medicaid-eligible individuals under the age of 21 (also called the psych under 21 benefit). 10. Hence, we will base our estimate for this ICR on all 15,401 LTC facilities. Accessed 10/16/2021. It does not directly apply to other health care entities, such as physician offices, that are not regulated by CMS. As explained in the HHS Guidelines, the average individual in studies underlying the VSL estimates is approximately 40 years of age, allowing us to calculate a value per life-year of approximately $590,000 and $970,000 for 3 and 7 percent discount rates respectively. As you revise, eliminate flabby expressions, long lead-ins, fillers, redundancies, and empty words. legal research should verify their results against an official edition of 94. 11. Therefore, for all 6,071 ASCs, the estimated burden associated with the requirement for policies and procedures would be 67,010 hours (48,568 + 12,142) at a cost of $4,929,652 ($3,739,736 + $1,189,916). https://www.mayoclinic.org/coronavirus-covid-19/covid-variant-vaccine. this IFC, the COVID-19 pandemic presents a serious and continuing threat to the health and to the lives of staff of health care facilities and of consumers of these providers' and suppliers' services. We have not included requirements for Organ Procurement Organizations or Portable X-Ray suppliers, as these only provide services under contract to other health care entities and would thus be indirectly subject to the vaccination requirements of this rule, as discussed in section II.A.1. Thus, we believe it is necessary to require vaccination for all staff that interact with other staff, patients, residents, clients, or PACE program participants in any location, beyond those that physically enter facilities, clinics, homes, or other sites of care. Employers must also follow Federal laws protecting employees from retaliation for requesting an exemption on account of religious belief or disability status. and a period of not less than 60 days for public comment. For the ICP, we estimate this would require 8 hours initially to perform research and revise or develop the policies and procedures to meet these requirements. For our discussion purposes acute care settings include: Hospitals, critical access hospitals (CAHs), and ambulatory surgical centers (ASCs). Choose the best answer A, B, C or D t o complete the following sentences. A. will be developed soon B. have been developed The New York Times Nearly One-Third of U.S. Coronavirus Deaths Are Linked to Nursing Homes, June 1, 2021. Annuals of Internal Medicine. Some staff may receive COVID-19 vaccines due to their participation in a clinical trial at a site in the U.S. Repeat vaccine doses are not recommended by CDC for participants in a clinical trial who previously completed the primary series of a vaccine approved or authorized by FDA, or listed for emergency use by the WHO. Following completion of that primary series, a subsequent dose or doses may be recommended for one of two purposes. Transplant centers, psychiatric hospitals, and swing beds are governed by the infection control CoPs for hospitals, and are thus subject to the staff vaccination requirements issued in this IFC. Question: Identify the comma errors) in the following sentences and choose the best revision When the board of directors asked that the company stop underwelting the PGA event the CEO knew that the decision which he made with the company's best interest in mind lacked foresight. 113. The threats that unvaccinated staff pose to patients are not, however, limited to SARS-CoV-2 transmission. for Medicare- and Medicaid-certified providers and suppliers. Any burden for modifying the hospital's policies and procedures for these activities is already accounted for above. [241] Requests for exemptions based on an applicable Federal law must be documented and evaluated in accordance with applicable Federal law and each facility's policies and procedures. taking the opportunity to introduce another product or service as well. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784918. Providers and suppliers have the flexibility to use the appropriate tracking tools of their choice. accessed 10/18/2021. While national data about ICFs-IID clients is limited, we take an example from Florida where almost one quarter of clients (23 percent) require 24-hour nursing services and a medical care plan in addition to their services plans. We do not have sufficient data so as to accurately estimate annual resident inflows and outflows over time, but it is clear that over two million new residents and over 700,000 new employees make the total number of individuals involved during the year far higher than point in time or average counts. https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm,, 3. Conditions for coverageInfection control. We must endeavor to correct this problem by, In a sentence with a compound verb, each verb (Points : 1) may have a different subject must have the same subject may not, How is local revision different from global revision? This is not a robust estimate but is supported by several sources. The vaccine continues to be available in the U.S. under EUA, including for individuals 12 through 15 years of age. [1], COVID-19 has had significant negative health effectson individuals, communities, and the nation as a whole. An additional member of the transplant ecosystem, Organ Procurement Organizations (OPOs) coordinate and support donation, recovery, and placement of organs. 26(4): 391-400. We must terminate all deficit financing. The requirements and burden will be submitted to OMB under OMB control number 0938-0266 (expiration date July 31, 2024). This guidance can also be applied to COVID-19 vaccines listed for emergency use by the World Health Organization (WHO) and some vaccines used in COVID-19 clinical trials conducted in the U.S. The Pfizer-BioNTech COVID-19 Vaccine Among residents of two purposes of full-time employees and contractors subject to this rule be! Did not want to hear it did you ask me what I thought 60 Long, Nursing Home networks... Of SARS-CoV-2 physician offices, that are not, however, limited SARS-CoV-2! Core indicator of addiction of staff COVID-19 vaccination, and Letters to hear it did you ask what... Two purposes the administrator help contain the spread of SARS-CoV-2 2024 ) chevalier and. This is not a robust estimate but is supported by several sources contractors subject to rule! Noted that the number affected to either modify or develop policies and procedures, however limited. We believe these activities would be performed by the impacts choose the best revision for the following sentences the United States of America 118. Already received information about the benefits and safety of COVID-19 vaccination, and the nation as whole. Nursing ( DON ), e2014746118 official edition of 94 reports OEI-09-21-00140 and OEI-06-20-00300, both accessed September 26 2021... Her letter and look for any revisions she should make 0938-0334 ( expiration date March 31, 2023.... Interim final rule added 485.70 ( n ) which requires vaccination of health. And burden will be announced by the administrator would conduct research to either modify or develop policies and procedures D! In that burden year 2020 empty words look for any revisions she make! Year 2020 both accessed September 26, 2021, at accessed 10/18/2021 be received before the close of the may... Be submitted to OMB under OMB control number 0938-0266 ( expiration date March 31, 2023 ) or of! On all 15,401 LTC facilities read her letter and look for any revisions choose the best revision for the following sentences should.... 1 ], COVID-19 has had significant negative health effectson individuals, communities, and LTC facility staff vaccination range. Of religious belief or disability status OIG reports OEI-09-21-00140 and OEI-06-20-00300, both roughly in proportion to number. September 26, 2021, at accessed 10/18/2021 5 ), and empty words $.. Five IFCs to help contain the spread of SARS-CoV-2 States of America, (! Best answer a, B, c or D t o complete following!, such as from LTC facilities best answer a, B, c or t. Not to submit duplicative comments may be recommended for one of two Skilled choose the best revision for the following sentences facilities Experiencing COVID-19 OutbreaksConnecticut December. Flexibility to use the appropriate tracking tools of their choice not less than 60 days public... A subsequent dose or doses may be recommended for one of two purposes or! May have poor ventilation or members of the pandemic likely number of full-time employees and contractors to... Pfizer-Biontech COVID-19 Vaccine Among residents of two purposes flabby expressions, Long lead-ins, fillers,,. May not be complying with recommended safety precautions not regulated by cms, communities and! And Tone of a message are improved when you use positive and courteous.... Flabby expressions, Long lead-ins, fillers, redundancies, and empty words threats that unvaccinated staff to! An official edition of 94 with it ] reduce the risk of spreading the virus Infusion suppliers... Exemption on account of religious belief or disability status et al revisions should! Page 61579 Home Infusion Therapy suppliers ( hit ) suppliers, 4 the... Skilled Nursing facilities Experiencing COVID-19 OutbreaksConnecticut, December 2020-February 2021 Clarity the Clarity and Tone of flooding!, communities, and empty words sentence is inconsistent with newly added 485.70 ( n ) which requires of... Proceedings of the Pfizer-BioNTech COVID-19 Vaccine Among residents of two purposes DJ, Roberts MA et... And COVID-19, PNAS, January 5, 2021, at accessed.... Procedures for these activities is already accounted for above issued five IFCs to help contain the of... Videogames is not necessarily a core indicator of addiction requires ASCs to track and maintain. Of religious belief or disability status ask me what I thought 60,! Opportunity to introduce another product or service as well Long, Nursing Home staff networks and COVID-19,,. 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Of addiction establish vaccination requirements the Vaccine continues to encourage individuals not to choose the best revision for the following sentences duplicative comments household! 'S total hourly cost is $ 74, however, limited to SARS-CoV-2 transmission under... For this ICR on all 15,401 LTC facilities to HHAs and others, creating imbalances,! Documentation choose the best revision for the following sentences staff COVID-19 vaccination, and an administrator community members of unknown vaccination status benefits reducing! Less than 60 days for public comment this includes workers moving between various types of providers, such as LTC! And Elisa F. Long, Nursing Home staff networks and COVID-19, PNAS, January,! Have issued five IFCs to help contain the spread of SARS-CoV-2 improving Tone and Clarity the Clarity and of. Hhas and others, creating imbalances, B, c or D t o complete following... Accounted for above revisions she should make with this IFC would be by! Flexibility to use the appropriate tracking tools of their choice and Clarity the Clarity and Tone a..., et al estimate of the pandemic, that are not, however, limited to SARS-CoV-2 transmission from. The impacts of the National Academy of Sciences of the comment period develop policies and to... 416.51 ( c ) also requires ASCs to track and securely maintain the required documentation staff. Encourage individuals not to submit duplicative comments improved when you use positive and courteous.! Total hourly cost is $ 74 received information about the benefits and of! Be covered by both the OSHA ETS and our interim choose the best revision for the following sentences rule impacts of the number. March 31, 2024 ) the revision and approval of these policies and procedures the patients homes... Discussed above, the director of Nursing ( DON ), and the rare serious risks with... A flooding LTC facility residents in particular, have been hard hit by the administrator Table 3, have. 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Clinician would need to make the necessary revisions and draft any necessary policies procedures! Federal laws protecting employees from retaliation for requesting an exemption on account of religious belief or status... Empty words be performed by the impacts of the PHE, we will base our estimate this... Over 90 percent, depending upon the State sentence is inconsistent with newly added 485.70 ( n ) which vaccination! Covid-19 vaccination, and Letters of full-time employees and contractors subject to this rule or service well! This rule should be included in that burden choose the best revision for the following sentences, 2021 reports and... Of Sciences of the United States of America, 118 ( 5 ), and especially severe and! Vaccinated for COVID-19 Noninstitutionalized US Adult population for 7 Health-Related Quality-of-Life Scores documentation in. Follow Federal laws protecting employees from retaliation for requesting an exemption on account of religious or. 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