Rural hospitals fear losing staff over Biden’s new vaccine mandate

A health worker administers a COVID-19 vaccine to a resident at the Jordan Valley Community Health Center in Springfield, Missouri, in this file photo from June 29.

Liz Sanders / Bloomberg via Getty Images

Adam Willmann was born at Goodall-Witcher Hospital in Clifton, a small town in central Texas. He is now the CEO and he fears his hospital will have to stop giving birth.

This is because some of the experienced nurses in the Goodall-Witcher Obstetrics Department are not vaccinated against COVID-19 and do not intend to be. But under a new federal mandate, hospitals will soon have to require their staff to be vaccinated.

“They are also approaching retirement age and a few of them have already said, ‘I’m just going to retire,'” said Willmann. “And then some other nurses said, ‘Well, I’m just going to go and work for my husband’s construction company.’ “

We’re sort of at that point where everyone that’s ready to get it, got it.

Willmann’s situation is not unique. Rural health care providers across the country are sounding the alarm bells on the new mandate which will begin as early as next month. The Biden administration wants everyone working in a healthcare setting – from hospitals to nursing homes to dialysis centers – to be fully immunized against COVID-19.

But in rural areas where vaccination rates are low and hiring is already difficult, hospital managers fear that a staff shortage will force them to turn away patients.

Willmann has gone to great lengths to get all of his 250 employees to take one of the COVID vaccines, but has peaked at around 70%. It’s well above the rate in the surrounding community, but still not enough.

“We’re sort of at that point where everyone who’s willing to get it has got it,” he said.

Signs showing the correct way to cough and wash your hands are displayed outside a business in Clifton, Texas in 2020.

Signs showing the correct way to cough and wash your hands are displayed outside a business in Clifton, Texas in 2020.

Dylan Hollingsworth / Bloomberg via Getty Images

“We did not take this decision lightly”

This stagnation in vaccination rates at medical facilities across the country is what prompted the Biden administration to seek a warrant, said Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services.

“We didn’t take this decision lightly,” Brooks-LaSure said in an interview with NPR.

The agency is expected to finalize the details of the new requirement within the next month. It plans to suspend Medicare and Medicaid funding to institutions unless they meet the mandate.

Brooks-LaSure said she knows some hospitals and care homes fear the vaccines mandate could cause staff shortages, especially in rural areas. But she said healthcare workers who aren’t vaccinated and get sick or need to be quarantined are also leading to staff shortages.

The government is also concerned about security. “It is very clear from the data that unvaccinated staff affects both patients entering facilities as well as their colleagues,” said Brooks-LaSure.

Brooks-LaSure said the staff issues might not be as bad as some fear. She referred to the experience of Maine, where Governor Janet Mills established a state mandate for healthcare workers.

“Even though there was a lot of noise around the meaning of these terms, the actual number of healthcare workers who resigned was very limited,” Brooks-LaSure said.

The warrants mean more vaccinations. But also, hate mail

In rural Coös County, New Hampshire, Tom Mee looked at the problems of getting a warrant in place. He is the CEO of North Country Healthcare, which decided to require vaccines for people who work at its three hospitals after the Food and Drug Administration gave full approval to the Pfizer vaccine.

Staff have 60 days to get vaccinated. “Our big day is October 23, and somehow our workforce will be 100% vaccine compliant,” Mee said.

Mee said the move was the right thing to do to protect the health of patients and employees. But it was difficult to implement. He received hate mail. But the mandate is working: a month ago, 78% of the staff were vaccinated, but now it is up to 90%.

But he said it was inevitable that the tenure would mean a handful of employees resign or be forced to leave, gaps he expects he can fill by relocating staff.

“It’s a scene you’re going to see repeat itself across the United States,” Mee said. “I have been in the healthcare industry for 34 years and have never seen anything like it before.”

In this April 26 file photo, Connecticut National Guard physician Todd Smith administers a COVID-19 vaccine at a mass vaccination site in East Hartford, Connecticut.

In this April 26 file photo, Connecticut National Guard physician Todd Smith administers a COVID-19 vaccine at a mass vaccination site in East Hartford, Connecticut.

Jessica Hill / AP

Rural hospitals want help from Biden administration

In many areas, there are not enough qualified people to fill health vacancies, especially during a pandemic, said Alan Morgan, CEO of the National Rural Health Association.

Morgan urges the Biden administration to come up with a plan to help deal with expected staff shortages once the mandate goes into effect, similar to federal strike teams sent to communities struggling to handle surges of overwhelming COVID cases local medical resources.

Morgan suggested teams could be drawn from the U.S. Public Health Department, National Guard or the Federal Emergency Management Agency to help rural hospitals.

Rural hospitals and clinics may be able to hire temporary relief nurses to come to their communities and use federal funding to help offset expenses, Morgan said. But urban hospitals generally offer more attractive remuneration. Morgan is also concerned about a gap between when the warrants come into effect and when a new tranche of federal funding becomes available.

Morgan asked administration officials, hoping to get a signal that contingency planning is underway, and has so far received no reassuring response.

He fears that even a small number could create disproportionate problems for rural hospitals. “Even if this would only affect 2% to 5% of hospital staff, it will create a disruption in service,” Morgan said.

“Are we going to have to transfer the existing patients? Are we going to have to stop the incoming patients?”

Copyright 2021 NPR. To learn more, visit https://www.npr.org.

In this April 5 file photo, Leanne Montenegro, 21, covers her eyes as she receives a COVID-19 vaccine at a FEMA vaccination center in Miami.

In this April 5 file photo, Leanne Montenegro, 21, covers her eyes as she receives a COVID-19 vaccine at a FEMA vaccination center in Miami.

Lynne Sladky / AP

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