By HEATHER HOLLINGSWORTH and TAMMY WEBBER
Hospitals and nursing homes in the United States are bracing for worsening staff shortages as state-set deadlines arrive for healthcare workers to get vaccinated against COVID-19.
With ultimatums taking effect this week in states like New York, California, Rhode Island and Connecticut, the fear is that some employees will quit or be fired or suspended rather than getting vaccinated.
“How it’s going to play out, we don’t know. We are concerned about how this will exacerbate an already serious enough staffing problem, ”said California Hospital Association spokesman Jan Emerson-Shea, adding that the organization“ absolutely ”supports the immunization requirement of the state.
New York health care workers had until the end of Monday to get at least one dose, but some hospitals had already started to suspend or take action against holdouts.
Erie County Medical Center Corp. in Buffalo said about 5% of his hospital staff have been put on unpaid leave of absence, along with 20% of his nursing home staff. And the state’s largest healthcare provider, Northwell Health, said it has started removing unvaccinated workers from its system, although it said its workforce is being vaccinated at almost 100%.
“To those who have not yet made this decision, please do the right thing,” said New York Governor Kathy Hochul.
Some New York hospitals have prepared contingency plans that included reducing non-critical services and limiting nursing home admissions. The governor also made plans to seek help from members of the National Guard with medical training, retirees or vaccinated workers from out of state.
About a dozen states have immunization mandates covering healthcare workers in hospitals, long-term care facilities, or both. Some allow exemptions for medical or religious reasons, but these employees are often required to undergo regular COVID-19 testing.
States that have set such requirements already tend to have high vaccination rates. The highest rates are concentrated in the Northeast, the lowest in the South and Midwest.
The Biden administration will also require that the roughly 17 million workers in healthcare facilities who receive federal Medicare or Medicaid be fully immunized under a rule still under development.
This has worried some hospital officials, especially in rural communities where vaccination rates tend to be lower.
“We’re looking at the need to reallocate staff, in some cases just to maintain essential services, and there are going to be delays” in care, said Troy Bruntz, President and CEO of McCook Community Hospital , Nebraska.
He said 25 of the 330 hospital workers said they would quit permanently if they were to be vaccinated. The rest of the roughly 100 unvaccinated employees – a group that includes nurses as well as cleaning and maintenance staff – have not made a decision.
He also fears that it will be difficult to hire new workers when the hospital is already understaffed.
“It doesn’t give us too much confidence that it’s not going to turn into something less than a nightmare for American healthcare,” he said.
Many hospitals and nursing homes are already suffering from staff shortages because many nurses and others have resigned following pandemic-related burnout or left for lucrative jobs traveling from state to state. the other.
White House press secretary Jen Psaki noted that hospitals in Houston and Maine recently lost relatively small numbers of employees after asking employees to get vaccinated.
“We see in a lot of places that it works, it is effective. It creates more certainty and protection in their workforce, ”Psaki said.
In California, where health workers have until Thursday to get their full immunizations, some hospitals are planning layoffs, suspensions or moving people to other positions, Emerson-Shea said. She said many mobile nurses have turned down assignments in California due to state vaccine requirements.
But with a statewide mandate, health workers won’t be able to just quit their jobs and go to other hospitals, said Dr Jeff Smith, chief operating officer and executive vice president. of hospital operations at Cedars-Sinai Medical Center in Los Angeles. .
He expects about 97% of the approximately 17,000 Cedars-Sinai employees affected by the vaccination mandate to comply with the deadline. Another 1% asked for medical or religious exemptions. Those who fail to comply by Friday will be suspended for a week and fired on October 8 if they fail to comply or if there are no extenuating circumstances, he said.
The hospital was also able to hire more than 100 nurses over the past month and uses itinerant nurses.
“We’re in a good position, but we don’t want to downplay the challenges other hospitals are likely facing,” Smith said.
In Rhode Island, where the vaccination mandate goes into effect Friday, the state said hospitals can allow unvaccinated employees to continue working 30 days after the deadline in cases where their termination would compromise patient safety. The warrant is being challenged in court because it does not allow religious exemptions.
In states that do not have warrants, some hospitals impose theirs.
Ginger Robertson, a registered nurse who works in a mental health clinic at a hospital in Bismarck, North Dakota, has requested a religious exemption from her hospital’s vaccination requirement. She said she would look for another job if she didn’t get it.
“Honestly, I really love my job. I’m good at it. I appreciate my patients. I love where I am, ”she said. “So it’s a really tough place to have to choose between two things that I don’t want to do. I don’t want to leave and I don’t want to be vaccinated.
She said other nurses were also considering leaving what she called the “insulting” warrant.
“We feel demoralized, like we aren’t smart enough to make these choices on our own,” said Robertson.
A North Carolina-based hospital system announced Monday that more than 175 of its 35,000-plus employees have been laid off for failing to meet its COVID-19 vaccination requirements.
Last week, Novant Health announced that 375 workers had been suspended and had five days to comply. Almost 200 of them did so – including those who submitted approved exemptions – by Friday’s deadline, spokeswoman Megan Rivers said.
The Massachusetts mandate, issued by Republican Governor Charlie Baker, applies only to nursing homes, assisted living facilities, hospice programs and home care programs. It allows medical and religious exemptions but does not require regular testing. The deadline is October 31.
In Connecticut, a vaccination mandate for employees of public hospitals went into effect Monday. It does not apply to private hospitals, some of which have their own requirements. Medical and religious exemptions are possible, but anyone else who does not get vaccinated will be excluded from the workplace.
About 84% of New York’s more than 450,000 hospital workers were fully immunized as of Wednesday, according to state data. Nursing home data through Sunday showed about 89% of nursing home workers were fully immunized.
The New York City Hospital System reported a 95% vaccination rate for nurses and a higher rate for physicians.
In Missouri, which became a hotspot for COVID-19 over the summer, Mercy’s hospital system is requiring vaccinations among staff at its hundreds of medical centers and clinics in Missouri and neighboring states by Thursday. .
Anyone who does not comply by then will be given a 30-day unpaid suspension, said Mercy spokeswoman Bethany Pope.
Webber reported from Fenton, Michigan, and Hollingsworth from Mission, Kansas. Philip Marcelo and Mark Pratt in Boston; Michael Melia in Hartford, Connecticut; Michael Hill in Albany, New York; Skip Foreman in Charlotte, North Carolina; and Zeke Miller in Washington contributed to this story.
This story was first published on September 27, 2021. It was updated on September 30, 2021 to correct the title of Dr. Jeff Smith as Chief Operating Officer, not Chief Executive Officer.