Vaccination rates for rural hospital workers continue to lag

Rural hospital healthcare workers continue to lag behind COVID-19 vaccination rates as some executives choose to wait for a court to review conflicting state and federal regulations.

Less than half of 130 rural health officials surveyed in September and October said that at least 70% of their staff were fully vaccinated, indicating a small increase from vaccination rates for March and Aprilaccording to the new survey from the Chartis Center for Rural Health. Some rural hospital leaders refuse or postpone vaccinations due to conflicts with state and federal regulations.

Meanwhile, nearly half of respondents said they had to turn down patients in the past two months due to staff shortages, according to a recent Chartis survey.

“The fact that healthcare leaders don’t stand up for what medical science tells us is our greatest chance of defending or defeating the virus is scary,” said Michael Topchik, national leader at Chartis, adding that medical professionals have a lot of influence in close-knit relationships. rural communities. “We know that COVID is disproportionately ravaging rural and politically red areas in huge numbers, so it’s sad to see that politics has cost people their health and their lives.”

States such as Missouri, Alabama, Iowa and Florida, as well as other Republican-led states, argue that public health issues should be state-regulated. State officials are suing the federal government, arguing that their state exemptions replace vaccine requirements for private employers, which will be implemented next year with an interim final rule of the Centers for Medicare and Medicaid Services and the Occupational Safety and Health Administration.

Typically, federal law will override violations of state law. But there are unresolved questions about whether OSHA and CMS regulations fall within the purview of these agencies, said William Horton, a partner at Jones Walker.

“CMS is empowered to set eligibility and payment terms for federal health programs such as Medicare. However, a CMS generally cannot impose substantial requirements on the operation of a healthcare facility – this is mainly a function of state licensing laws and other government laws – as required by law, ”he said. “So it is at least hypothetically possible that both the CMS mandate and the conflicting state laws were valid and not inconsistent with each other, even if it were some sort of disastrous result. In short, it’s a real mess. “

“The OSHA requirements were designed to redefine state laws and make things more uniform across the country, but it’s unclear how things will change in the courts,” said Margot Wolf O’Donnell, partner at Benesch Friedlander Coplan & Aronoff.

“Does OSHA have what it takes to repeal these government laws? It has been stressful throughout the pandemic, ”she said.

O’Donnell added that the conflict is compounded by health systems that employ staff from different states.

According to a Chartis survey, as of September and October, 75% of rural hospital directors said they did not have staff to administer vaccinations at their facility. Of the 12.3% that required vaccinations, hospitals reported the loss of up to 5% of their medical staff.

While hospital leaders await a decision likely to be made by the Supreme Court, healthcare providers continue to grapple with potentially fatal labor shortages.

About 30% of respondents said that staffing problems associated with nursing care forced them to suspend the provision of services, often surgery.

“If some rural hospitals lose one nurse, this could deprive them of the ability to provide round-the-clock care,” Topchik said. “This could be a disaster.”

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