Hospitals, nursing homes and all other Medicaid-accepting facilities across Montana have been busy processing data on staff vaccination, exemptions and, in some cases, unemployment.
Feb. 14 marked the first deadline for the Centers for Medicare and Medicaid Services (CMS) COVID-19 vaccine mandate. All employees working at a facility receiving reimbursement from the federal agency are required to provide proof of at least one dose of vaccine or a medical or religious exemption.
At Benefis Health System in Great Falls, 37 employees opted to end their employment rather than get vaccinated or try for an exemption. The resignations were not concentrated in a specific department or employee type, according to Whitney Bania, senior communications specialist at Benefis.
About 4% of staff secured a medical or religious exemption and of those, 29% were medical deferral and 71% were religious deferrals.
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Those who fall into the vaccinated camp make up 94.6% of the employees.
Other health facilities have opted to be steadfastly tight-lipped about their compliance.
Bozeman Health will only report 83% of their staff are fully vaccinated. Hospital officials say the facility is compliant with the CMS requirements, but exemption requests are still being processed, according to Kallie Kujawa, transformation officer at Bozeman Health.
Kujawa would not say how many exemptions were submitted or how many workers were placed on leave due to non-compliance, claiming that reporting the numbers would jeopardize employee identity. There are 2,400 people employed at Bozeman Health.
The decision to not reveal the compliance breakdown was made out of a “desire to keep staff employed and protect their identity,” said Kujawa.
In Lewistown, where 340 people are employed at Central Montana Medical Center, a mix of exemption and vaccination brought the hospital into 100% compliance. The hospital has opted not to publish how workers complied with the rule due to confidentiality reasons, said Stephanie Prater, community relations manager at the facility.
Rich Rasmussen with the Montana Hospital Association said that keeping vaccination numbers private has been a traditional practice for the flu shot. He added that exemptions have also been a hallmark for flu vaccination for years.
“The difference here is that there are some who feel very strongly about (the COVID-19) vaccination,” said Rasmussen.
But COVID-19 differs greatly from seasonal flu starting with the mortality rate. Researchers estimate that COVID-19 is 10 times more deadly than most strains of flu, according to John Hopkins Medicine. And many people infected with the virus experience mild symptoms or are asymptomatic, thus transmitting the virus unknowingly. Long COVID can also be severe while little is known about the lasting impacts.
Rasmussen looked to pre-vaccination mitigation measures such as masking, social distancing and regular testing to keep COVID from infecting patients.
Accommodations will be made for those who work unvaccinated under an exemption.
House Bill 702, which bans vaccination requirements for any preventable disease including the traditional flu shot, may result in a pivot within hospitals.
“Masking might become a standard of care,” Rasmussen said.
Less than 2% of SCL Health Montana and Wyoming associates were non-compliant with the mandate and about 12% received a medical or religious exemption, meaning 98% of employees were compliant.
“Those who did not adhere to the deadline will be suspended for three days and considered voluntarily resigned if they refuse to comply,” according to an SCL Health press release.
At Billings Clinic, 15 of the 4,700 employees were non-compliant with the vaccination mandate, according to Community Relations Coordinator Zach Benoit. The number of religious or medical exemptions were not reported nor was the number of employees who ended employment over the requirement.
RiverStone Health also reported 100% compliance with 11% of staff members using an exemption. No employees were put on leave.
There is some concern that vaccine requirements could impact the ability to attract and hire health care workers.
Darcel Vaughn with Gallatin County Rest Home hasn’t lost any employees to the CMS mandate so far, but is hesitant to challenge any religious exemptions that come across her desk.
The Equal Employment Opportunity Commission (EEOC), which provides guidance for vetting religious exemption forms, tells administrators to look at the petitioner’s morals and ethics when approving requests while medical exemptions require proof in the form of a doctor’s note.
“How do I come out and decide that for people?” Vaughn asked when referring to religious exemptions adding that she could see lawsuits in the future if anyone denied a religious exemption.
Gallatin County Rest Home is a skilled nursing facility with some rehabilitation services with 56 employees on the payroll. Of those, 81% are vaccinated and 19% are exempt.
Vaughn is also responsible for the compliance status of any workers that come into her facility to provide services to residents, such as hospice care.
Gov. Greg Gianforte addressed vaccination compliance in an open letter to health care workers released last Friday where he stated that he will continue to challenge the mandate, calling it unconstitutional or otherwise unlawful.
Gianforte then encouraged the unvaccinated to consider using the religious and medical exemption forms, attaching the religious exemption form to the bottom of the letter. He added that some should consider talking to health care providers about vaccination.
“As Montanans who have faced a longstanding shortage of health care professionals, we simply can’t afford to lose you, your colleagues, your experience, and your compassionate, dedicated care due to President Biden’s vaccine mandate,” Gianforte wrote.
