Ballad Health CEO calls on CMS to allow flexibility with healthcare worker vaccination mandate

Alan Levine, chair and CEO of Johnson City, Tenn.-based Ballad Health, is requesting that CMS consider changes to the federal agency's COVID-19 vaccination mandate for healthcare workers to help address staffing shortages facing rural health systems as organizations educate people about the vaccines and increase vaccination rates among employees, according to CBS and ABC affiliate WJHL.

In a letter sent Jan. 3 on behalf of his 21-hospital system, Mr. Levine said CMS should consider allowing hospitals in health professional shortage areas to seek waivers from the mandate if they can demonstrate retention challenges.

"Those parts of the country which already suffer from shortages, and which are disadvantaged in terms of recruitment and retention, need to first do no harm in terms of staffing availability," he wrote. "Permitting health systems that can demonstrate staff retention challenges to seek waivers would be fair and would appropriately recognize the importance of balancing appropriate staffing levels at healthcare facilities with the administration's desire to increase vaccination rates among healthcare workers."

If CMS does not provide the option to seek a waiver, CMS should delay implementation of the mandate at least through June for facilities in health professional shortage areas, Mr. Levine said. He argued this will give these facilities time to implement policies and procedures to improve vaccination rates, and "help ensure that individuals who are living in rural communities are not disproportionately impacted by staffing shortages that may occur as a result of employees refusing the vaccine."

Mr. Levine's letter also calls on CMS to "take a flexible approach" regarding surveying for compliance with the mandate; not include appropriateness of medical or religious exemptions in the scope of compliance surveys; not task healthcare facilities with verifying COVID-19 vaccinations for contractors and vendors; and allow employees who have received one dose of the COVID-19 vaccine to perform their jobs while they await their second shot "so long as they are complying with policies to minimize the risk of transmission."

The letter comes after CMS released guidance and survey procedures Dec. 28 for the 25 states where its mandate for healthcare workers is not currently blocked by legal challenges. The guidance applies to facilities participating in the Medicare and Medicaid programs in those states, including Tennessee, where Ballad is based, as well as Washington, D.C., and U.S. territories.

According to the guidance, facilities are compliant if, by Jan. 27, they have established policies and procedures for ensuring eligible staff are vaccinated and all staff have received at least one dose, have a pending request for an exemption, have been granted a qualifying exemption, or have been identified as having a temporary delay as recommended by the CDC.

By Feb. 28, eligible staff must have completed the vaccination series (one dose of Johnson & Johnson or two doses of Pfizer or Moderna), have been granted an exemption or have been identified as having a temporary delay as recommended by the CDC.

"Given the new timelines released by CMS for compliance with the mandate, it is clear that the shots would have to be initiated by the end of January — well after the predicted peak of the omicron variant. Thus, we don't see how the current [mandate] helps mitigate the challenges before us," Mr. Levine wrote.

CMS released the guidance as the U.S. Supreme Court has scheduled a special hearing Jan. 7 to consider cases involving the mandate for healthcare workers and the Occupational Safety and Health Administration's vaccinate-or-test requirement for large businesses.

The nation's highest court will make a final ruling on the mandate for eligible staff at healthcare facilities. President Joe Biden's administration has asked that the court allow the mandate to take effect across the country. 

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