Healthcare employees at Medicare and Medicaid-certified facilities in Minnesota and 24 other states and the District of Columbia had to receive their first dose of a COVID-19 vaccine by Jan. 27 and must receive their second dose by Feb. 28.
The vaccination requirement applies to Medicare and Medicaid-certified ambulatory surgery centers, community mental health centers, comprehensive outpatient rehabilitation facilities, critical access hospitals, end-stage renal disease facilities, home health agencies, home infusion therapy suppliers, hospices, hospitals, intermediate care facilities for individuals with intellectual disabilities, clinics, rehabilitation agencies, public health agencies as providers of outpatient physical therapy and speech-language pathology services, psychiatric residential treatment facilities, programs for all-inclusive care for the elderly organizations, rural health, clinics/federally qualified health centers and long-term care facilities.
In Pipestone County, the requirement applies to Pipestone County Medical Center (PCMC), Good Samaritan Society and Ridge View Estates in Pipestone, and Edgebrook Care Center in Edgerton.
PCMC CEO Brad Burris said PCMC required full vaccination for staff by the original federally set date of Jan. 5. Out of PCMC’s 208 employees, 183 have been vaccinated, which equates to about 88 percent, and 25 were exempt.
Good Samaritan Administrator Stacy Mertens said Good Samaritan required employees to be vaccinated by Nov. 1 and that 95 percent of their employees were compliant. She said 95 percent of the 21 employees at Ridge View Estates were also compliant.
Good Samaritan Society Executive Director Mike Deuth said Edgebrook Care Center was adhering to the federal vaccine mandate and that the majority of its staff were already fully vaccinated.
Centers for Medicare and Medicaid Services (CMS) requires facilities to allow for exemptions to the vaccination requirement due to sincerely held religious beliefs and for medical reasons. Facilities have the flexibility to establish their own processes for employees to request exemptions.
According to the CMS, exemptions could be appropriate in certain limited circumstances, but should not be provided to any staff for whom it is not legally required or solely to evade vaccination. Facilities must develop a process for implementing additional precautions for any employees who are not vaccinated in order to mitigate the transmission and spread of COVID-19.
At PCMC, Burris said unvaccinated employees are required to self-monitor for symptoms and check their temperature twice a day. At Good Samaritan, Mertens said unvaccinated employees must be tested for COVID once a week or more based on the prevalence of the virus in the county. All employees at both facilities must wear face masks and Good Samaritan employees must also wear eye protection.
Mertens said there was push back from some employees about Good Samaritan’s vaccination requirement and that two people quit because they couldn’t get exemptions. Deuth said that the overall staff departures tied to the Good Samaritan Society’s vaccine mandate was less than 1 percent across the organization’s 22-state footprint.
CMS works with state survey agencies to review compliance with Medicare/Medicaid regulations and has a variety of established enforcement remedies. For nursing homes, home health agencies and hospice, that includes civil monetary penalties, denial of payment and, as a final measure, termination from the Medicare and Medicaid program. The remedy for non-compliance among hospitals and certain other acute and continuing care providers is termination. According to CMS, its goal is to bring health care facilities into compliance and termination would generally occur only after providing a facility with an opportunity to make corrections and come into compliance.
Different states have different deadlines to comply with the COVID vaccination requirement due to legal battles about the mandate.
The Jan. 27 deadline for the first dose and Feb. 28 deadline for the second applies to California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Tennessee, Vermont, Virginia, Washington and Wisconsin, according to CMS. A preliminary injunction against the mandate had already been lifted in those states prior to a Jan. 13 Supreme Court decision to allow the vaccine mandate to proceed.
For 24 other states where the injunction had not previously been lifted, including Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia and Wyoming, the deadline for the first dose is Feb. 14 and the deadline for the second dose is March 15. In Texas, which also challenged the mandate, the deadline for the first dose is Feb. 22 and the deadline for the second dose is March 21.