Omicron threat looms as some hospitals suspend vaccination requirements amid legal battles

Pending litigation over federal COVID-19 vaccination requirements for healthcare workers has caused some hospitals and health systems to reevaluate their mandate decisions as the omicron variant spreads and the delta variant remains dominant in the U.S.

CMS suspended implementation and enforcement of its mandate after a federal judge in Louisiana issued preliminary injunctions Nov. 30. The injunction effectively expanded a separate order issued Nov. 29 by a federal judge in Missouri that temporarily paused the mandate in 10 states. 

With legal challenges in limbo, hospitals and health systems have made new decisions, including suspending their requirements.

The CMS requirements 

The CMS regulation is expected to cover more than 17 million workers in hospitals and other healthcare settings that participate in Medicare and Medicaid programs. 

To comply with the regulation, healthcare facilities must establish a policy ensuring staff are fully vaccinated by Jan. 4. Facilities are required to develop plans and processes to provide religious and medical exemptions and accommodations as appropriate. 

Although CMS on Dec. 2 suspended implementation and enforcement of its regulation pending developments in litigation, the agency said it "remains confident in its authority to protect the health and safety of patients in facilities certified by the Medicare and Medicaid programs." Challengers have argued that CMS does not have the authority to enact the rule.

Suspending mandates 

Since CMS suspended implementation and enforcement of its regulation, at least 13 healthcare organizations have announced they are suspending their mandates. 

Cleveland Clinic, for example, announced Dec. 2 that it is pausing the implementation of the health system's vaccination policy, which required employees and those who provide services with the health system to receive the vaccine or an approved exemption with accommodations. The health system said it will have additional safety requirements for unvaccinated workers, including periodic testing for those providing direct clinical care.  

Dallas-based Tenet Healthcare also will not enforce the CMS vaccination requirement for individuals working in its facilities, the for-profit hospital operator told staff in a letter shared with Becker's. Tenet said workers who are in a state that has previously issued a vaccination mandate must continue to follow the state or local requirement. The company continues to encourage vaccinations and will continue accepting exemption requests. 

Extending deadlines

Hospitals and health systems are extending their mandate deadlines, too, considering the recent court rulings. 

One of them is Hospital Sisters Health System, a 15-hospital, Catholic health system based in Springfield, Ill. HSHS announced Dec. 3 that it is keeping its newly established vaccination policy in place while courts review the federal rule for healthcare workers. The health system is extending the vaccination deadline from Dec. 6 to Jan. 31.

"We are proud that the HSHS COVID-19 vaccination rate has climbed to 81 percent," HSHS President and CEO Damond Boatwright said Dec. 3 in a news release. "HSHS has been advocating the COVID-19 vaccine since it became available. Like Pope Francis, who has called on nations to work towards a global common good, we believe this also holds true when it comes to vaccines in general."

The vaccination requirement applies to HSHS colleagues, licensed practitioners, students, trainees, volunteers and individuals who provide care, treatment, or other services for the health system's facilities and/or patients, under contract or another arrangement. It does not apply to fully remote employees. Exemptions are allowed.

Coeur d'Alene, Idaho-based Kootenai Health is also delaying the effective date of its vaccination requirement from Dec. 6 to Dec. 13, according to the Coeur d'Alene Press.

In a statement shared with the newspaper, the health system said the court ruling "does not prevent healthcare providers from taking steps to lessen the impact of COVID-19. The CMS rule was designed to protect health and safety and Kootenai Health still believes this to be true. As a result, Kootenai Health will continue to move forward with a COVID-19 vaccination requirement like hospitals in Boise, [Idaho], and Spokane, [Wash.], did even before the CMS rule."

COVID-19 remains a concern

Hospitals and health systems are reevaluating vaccination requirements amid the emergence of the omicron variant, which, as of Dec. 6, has been detected in at least 18 states. 

At the same time, public health experts nationwide have identified the delta variant as the current main threat. During a Dec. 3 news briefing, Rochelle Walensky, MD, director of the CDC, said, "We should remember that 99.9 percent of cases in the country right now are from delta." 

Epidemiologists have also warned that the Northeast and Upper Midwest — where Wisconsin and Illinois on Dec. 2 reported the highest single-day increase in COVID-19 cases seen up to that point in 2021 — will still likely face a winter surge driven by the delta variant.

This means some organizations already grappling with staffing strain could see those issues exacerbated.

Lincoln, Neb.-based Bryan Health said it is not getting rid of its vaccination mandate but that, for now, it will not fire employees who have not met the deadline to get vaccinated or receive an approved exemption, the Journal Star reported Dec. 5. 

According to the newspaper, the health system previously said 10 employees resigned or were terminated after declining to get the vaccine, and another 300 were granted an exemption. 

As of Dec. 5, 180 of the health system's more than 5,600 employees had declined to get vaccinated and had not received an exemption, according to a statement shared with Becker's. Those employees were not terminated. 


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