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With a deadline approaching for mandated COVID-19 vaccinations for healthcare workers, rural facilities are expressing concerns about the impact on already short staffs.
Under regulations issued on Nov. 4, the Centers for Medicare & Medicaid Services will require facilities to ensure their staffs are vaccinated. The edict involves institutions providing care for Medicaid and Medicare patients.
In Texas County, the deadline poses big challenges at Texas County Memorial Hospital, one of the largest employers in the county and biggest healthcare provider in the area where about half of its 320 employees are unvaccinated.
TCMH — along with other medical clinics and nursing homes in the region — must have its employees receive the first dose of a two-dose vaccine or a one-dose vaccine before providing any care, treatment or service by Dec. 6. All must be fully vaccinated by Jan 4.
Chris Strickland, CEO of TCMH, said the hospital, like other rural facilities, has not required its employees to be vaccinated, but knew eventually the federal mandate might be instituted. Vaccinated workers have been eligible for prize drawings, but the hospital has declined to force its staff to become vaccinated. With the writing on the wall, some employees have already retired or exited the medical field. Others left to take lucrative paying jobs as traveling nurses. That left employment rosters with shortages.
It is not clear how many local workers may refuse the shot and lose their job. The prospect, said Strickland, is deeply troubling how that may affect the county-owned hospital that already has unfilled jobs throughout its campus on South Sam Houston Blvd. And it is unclear whether legal challenges by a coalition of 10 state attorneys general in the U.S. District Court Eastern District of Missouri might be successful. The suit follows legal efforts intended to block other directives requiring large businesses to ensure their workers are either vaccinated or tested regularly and that federal contractors employ vaccinated staff.
Rural institutions — such as TCMH, Ozarks Healthcare in West Plains, Salem Memorial District Hospital in Salem and Phelps Health in Rolla — could be deeply affected. Some larger hospitals — such as the Mercy and Cox in the Springfield area — earlier mandated shots for its staffs and cleared the hurdle. It said most workers complied when faced with losing employment.
Texas County Memorial Hospital formed a panel that will follow models at larger institutions that will offer exemptions based on medical or religious reasons. Supervisors are meeting with workers about their options.
Most Missouri healthcare systems, with hospitals concentrated in urban and suburban areas, have already implemented their own mandates, said Dave Dillon, spokesman for the Missouri Hospital Association.
The Missouri Hospital Association has not taken a formal position on vaccine mandates for healthcare staff, Dillon said. Still, he noted such mandates are not new for Missouri hospitals, which commonly require staff to be immunized against the flu and other illnesses. “It tends to be independent and rural hospitals that are holdouts” for the COVID vaccine requirement, he said. “We certainly know that even before the pandemic rural hospitals faced a workforce challenge…where there are differences there’s probably a good reason.” But the organization believes vaccine mandates can be effective, Dillon said. A vaccinated healthcare workforce is a strong signal to communities to do the same, he added. “Many of the healthcare organizations that put mandates in place on their own before the federal government mandate came into effect had very few members of their teams that ended up not getting vaccinated,” Dillon said.
TCMH’s vaccination rate is significantly higher than the populace it serves. In Texas County, only about 30 percent of the population is vaccinated. In recent weeks, the figure has stalled, but vaccinations increased as booster shots became available. Additionally, more school-age students are now eligible for shots.