Hospitals fear staff shortages as vaccine deadlines approach

US hospitals and nursing homes are bracing for worsening staffing shortages as state deadlines for healthcare workers to get vaccinated against COVID-19 arrive.

With ultimatums taking effect this week in states like New York, California, Rhode Island and Connecticut, the fear is that some employees will resign or allow themselves to be fired or suspended instead of getting vaccinated.

“We don’t know how this will play out. We are concerned about how it will exacerbate an already serious staffing problem, ”said California Hospital Association spokesman Jan Emerson-Shea, adding that the organization“ absolutely ”supports the state’s vaccination requirement.

New York health care workers had until the end of the day Monday to receive at least one dose, but some hospitals had already begun to suspend or take action against the holdouts.

Erie County Medical Center Corp. in Buffalo said about 5% of its hospital workforce has taken unpaid leave for not being vaccinated, along with 20% of the staff at its nursing home. And the state’s largest healthcare provider, Northwell Health, said it has started removing unvaccinated workers from its system, though it said its workforce is nearly 100% vaccinated.

“For those who have not made that decision yet, do the right thing,” said New York Governor Kathy Hochul.

Some New York hospitals prepared contingency plans that included cutting non-critical services and limiting admissions to nursing homes. The governor also made plans to summon the help of members of the National Guard with medical training, retirees or vaccinated workers from out of state.

About a dozen states have vaccination mandates that cover healthcare workers in hospitals, long-term care facilities, or both. Some allow exemptions for medical or religious reasons, but those employees are often required to undergo regular COVID-19 testing.

States that have such requirements tend to already have high vaccination rates. The highest rates are concentrated in the Northeast, the lowest in the South and the Midwest.

The Biden administration will also require the roughly 17 million health facility workers who receive Medicare or federal Medicaid to be fully vaccinated under a rule that is still being developed.

That has worried some hospital officials, particularly in rural communities where vaccination rates tend to be lower.

“We are looking at the need to reassign staff, in some cases just to maintain essential services, and there will be some delays” in care, said Troy Bruntz, president and CEO of Community Hospital in McCook, Nebraska.

He said 25 of the 330 hospital employees said they would definitely quit if they had to get vaccinated. The rest of the roughly 100 unvaccinated employees, a group that includes nurses and cleaning and maintenance personnel, have not decided.

He is also concerned that it will be difficult to hire new workers when the hospital is already understaffed.

“It doesn’t make us feel too confident that this will not become anything less than a nightmare for American healthcare,” he said.

Many hospitals and nursing homes are already experiencing staff shortages because many nurses and others have quit as a result of pandemic-related burnout or left for lucrative jobs traveling from one state to another.

White House press secretary Jen Psaki noted that hospitals in Houston and Maine recently lost a relatively small number of employees after requiring employees to get vaccinated.

“We are seeing in many places that this is working, it is effective. It is creating more certainty and protection in its workforce, ”said Psaki.

In California, where healthcare workers have until Thursday to get fully vaccinated, some hospitals anticipate layoffs, suspensions or the transfer of people to other positions, Emerson-Shea said. He said that many traveling nurses have turned down assignments in California due to the state’s requirement for vaccinations.

But with a state mandate, healthcare workers won’t be able to just quit their jobs and go to other hospitals, said Dr. Jeff Smith, chief executive officer and executive vice president of hospital operations at Los Angeles-based Cedars-Sinai Medical Center. .

He expects about 97 percent of the nearly 17,000 Cedars-Sinai employees affected by the vaccine mandate to comply by the deadline. Another 1 percent have applied for medical or religious exemptions. Those who do not comply by Friday will be suspended for a week and fired on October 8 if they do not comply or if there are no extenuating circumstances, he said.

The hospital was also able to hire more than 100 nurses last month and uses some travel nurses.

“We’re in a good place, but we don’t want to minimize the challenges that other hospitals are likely to face,” Smith said.

In Rhode Island, where the vaccination mandate goes into effect Friday, the state said hospitals can allow unvaccinated employees to continue working 30 days after the deadline in cases where firing them compromises patient safety. The mandate is being challenged in court because it does not allow religious exemptions.

In states that do not have mandates, some hospitals are imposing their own.

Ginger Robertson, a registered nurse who works at a hospital mental health clinic in Bismarck, North Dakota, has applied for a religious exemption from her hospital’s vaccination requirement. He said he will look for another job if he doesn’t get it.

“Honestly, I really love my job. I’m good at it. I enjoy my patients. I enjoy where I am, ”he said. “So this is a really difficult place, having to choose between two things that I don’t want to do. I don’t want to leave and I don’t want to get vaccinated. “

She said other nurses are also considering dropping what she called the “insulting” mandate.

“We feel demoralized, like we aren’t smart enough to make these decisions for ourselves,” Robertson said.

A North Carolina-based hospital system announced Monday that more than 175 of its more than 35,000 employees have been laid off for failing to meet their COVID-19 vaccination requirement.

Last week, Novant Health announced that 375 workers had been suspended and given five days to comply. Nearly 200 of them did, including those who filed approved waivers, before Friday’s deadline, spokeswoman Megan Rivers said.

The Massachusetts mandate, issued by Republican Governor Charlie Baker, applies only to nursing homes, assisted living facilities, hospice programs, and home care programs. It allows medical and religious exemptions, but does not require periodic testing. The deadline is October 31st.

In Connecticut, a vaccine mandate for state hospital employees went into effect Monday. It does not apply to private hospitals, some of which have their own requirements. Religious and medical exemptions are possible, but anyone else who does not get vaccinated will be barred from the workplace.

About 84% of New York’s more than 450,000 hospital workers were fully vaccinated as of Wednesday, according to state data. Nursing home data as of Sunday showed that about 89% of nursing home workers were fully vaccinated.

The New York City hospital system reported a 95% vaccination rate for nurses and a higher rate for physicians.

In Missouri, which became a severe focus of COVID-19 over the summer, Mercy’s hospital system requires vaccinations among staff at its hundreds of medical centers and clinics in Missouri and neighboring states by Thursday.

Anyone who does not comply by then will be placed on an unpaid 30-day suspension, Mercy spokeswoman Bethany Pope said.


Webber reported from Fenton, Michigan and Hollingsworth from Mission, Kansas. Philip Marcelo and Mark Pratt in Boston; Michael Melia in Hartford, Connecticut; Michael Hill in Albany, New York; Skip Foreman in Charlotte, North Carolina; and Zeke Miller in Washington contributed to this story.

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