Vaccine mandate for North Big Horn Hospital goes into effect

By Ryan Fitzmaurice

With the release of government rules on November 4, all hospital employees will need to be vaccinated by January 4, 2022, or they will be placed on leave.

Along with the Occupational Safety and Health Administration releasing rules for their regulations requiring that all businesses with 100 employees or more  mandate vaccinations or implement weekly testing, the  Center for Medicare & Medicaid Service released their new rules requiring vaccination of staff within all Medicare and Medicaid-certified facilities. 

One of the most stark differences between the two mandates is that the CMS vaccination requirement does not give facilities the option to implement weekly testing in lieu of vaccination. Only medical and religious exemptions are included in the rules. 

“Medicare and Medicaid-certified facilities are expected to comply with all regulatory requirements, and CMS has a variety of established enforcement remedies. For nursing homes, home health agencies, and hospice (beginning in 2022), this includes civil monetary penalties, denial of payment and even termination from the Medicare and Medicaid program as a final measure,” a FAQ released by CMS on November 4 states. “The remedy for non-compliance among hospitals and certain other acute and continuing care providers is termination (of payment), however, CMS’s goal is to bring health care facilities into compliance.”

North Big Horn Hospital CEO Eric Connell said the rules are in line with what the district expected and the district has prepared for them. The hospital is actually subject to both the OSHA mandate and the CMS mandate, but the hospital must follow the most strict and stringent rules, Connell said. 

The hospital’s hands are largely tied, Connell stated in an October 22 email to the Lovell Chronicle. The Medicare program contributes over 50 percent of the district’s revenue. 

There are two important dates in complying with the mandate. The first is December 4, which is the deadline for employees to submit a medical or religious exemption and January 4, when the hospital would be at risk of losing funding if not in compliance. 

“We are allowing those exemptions,” Connell said. “We are supplying the forms and granting those requests as appropriate, in concordance for how those exemptions fall under the law. What constitutes a religious exemption is a real grey area, so we are doing our best to understand it and apply it fairly. 

CMS, in the FAQ, encouraged facilites to review the Equal Employment Opportunity Compliance Manual for Religious Discrimination for more information on religious exemptions.

In regard to the medical exemptions, CMS states: “Facilities must ensure that all documentation confirming recognized clinical contraindications to COVID-19 vaccinations for staff seeking a medical exemption are signed and dated by a licensed practitioner…Additionally, a statement by the authenticating practitioner recommending that the staff member be exempted from the facility’s COVID-19 vaccination requirements is also expected.”

Connell said the facility will handle the process of responding to the rules one step at a time.

“We’re working through it,” Connell said. “We’re going to continue to provide the best quality care. We’ll see what the next few weeks bring.”