Memorandum Summary: Effective 10-26-22, this memo has been superseded by QSO-23-02-ALL, Revised Guidance for Staff Vaccination Requirements. • CMS is committed to ensuring America’s healthcare facilities respond effectively in an evidence-based way to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE). • On November 05, 2021, CMS published an interim final rule with comment period (IFC). This rule establishes requirements regarding COVID-19 vaccine immunization of staff among Medicare- and Medicaid-certified providers and suppliers. • CMS is providing guidance and survey procedures for assessing and maintaining compliance with these regulatory requirements. • The guidance in this memorandum specifically applies to the following state: Texas. • States that are not identified above are expected to continue under the timeframes and parameters identified in either the December 28, 2021 or January 14, 2022 memoranda (QSO-22-07-ALL-Revised and QSO 22-09-ALL-Revised).