The Ector County Hospital board voted 4-3 to comply with a federal mandate that requires all hospital employees to be vaccinated against COVID-19 with only two pathways for an exemption.
Medical Center Hospital CEO Russell Tippin said Tuesday that Ector County’s public hospital, like all hospitals in the United States, faces both a federal mandate from the Biden administration as well as a Center for Medicare and Medicaid Services (CMS) mandate to require healthcare worker vaccinations to receive federal funding.
While a pending lawsuit on the federal mandate has a stay, there is not a current stay on the CMS mandate. The CMS funds MCH between $170 to $200 million a year.
A U.S. appeals court on Friday upheld its decision to put on hold an order by Biden for companies with 100 workers or more to require COVID-19 vaccines, rejecting a challenge by his administration. The now combined lawsuits have been sent to the 6th Circuit. Texas Attorney General Ken Paxton is also suing the administration.
Tippin said the board voted to enact a mandate policy that mirrors the CDC recommendation adding that if the Paxton lawsuit is successful that MCH “will adjust our timeline with it as well.”
The roughly 2,200 employees at MCH have until Dec. 5 to get their first vaccine and until Jan. 4 for the second. Those getting a Johnson & Johnson (single) vaccine have until Dec. 5. A more important deadline, Tippin said, is looming for employees who do not want the vaccine.
Next Tuesday is the last day for employees to file for an exemption. Exemptions can be acquired two ways. The first is a medical disability waiver that must be completed by a qualified healthcare provider and the second is to turn in paperwork for a “sincerely” held religious belief exemption.
Both waivers will go to a hospital committee for approval or rejection.
Tippin said MCH staff that are considered fully vaccinated now stands at about 65 percent. He said the board had no choice but to establish the policy as the hospital would be bankrupt without the CMS funding. He said the mandates from the government are devastating to hospitals everywhere that have been working non-stop since COVID started about two years ago.
“What are we going to do? Never has there been such a huge health care problem and the government comes in and makes it more difficult to put qualified doctors, nurses, and housekeepers in place. … Why would they (the Biden administration) enact this now when we are struggling to have staff to take care of people?”
He said the board meeting featured several employees who pleaded with the board to not force vaccines. He said it was an emotionally charged meeting. “Our hope is that the staff will get vaccinated, or get a waiver done in time,” Tippin said. “We cannot wait on this for the lawsuits to be settled. We are in a no-win situation.”
Of those unvaccinated at MCH, Tippin said, nurses are the largest number of unvaccinated because nurses make up the majority of the staff.
He said a loss of any number of employees during this time of short-staffing could mean the start of changing the capabilities of what MCH can do. “We may have to drop from 100 surgeries a day to maybe 40 or 60 or change clinic times from closing at 10 to closing at 8. … The other option is we will shut our doors if we don’t get the (federal) money.”
The 4-3 vote included Bryn Dodd, Wallace Dunn and Kathy Rhodes voting against the mandate.
Tippin on Tuesday also addressed the final CMS report on a complaint made about patient care. The complaint, which did not come from the mother of a teen patient shown in a photo that went viral on social media., was about the COVID patient having a large plastic bag over her body and head as she sat in a wheelchair on oxygen at MCH.
CMS sent an investigator to MCH last month to discuss MCH policy on how COVID patients are transported through the hospital. Tippin said MCH had already changed their transport policy prior to the CMS visit after the complaint.
Tippin said the investigator was walked through the process, which had been changed to what he described as a “halo” drape that used PVC pipe over a bed or wheelchair to protect the patient and staff and other hospital patients during transport.
Initially, the investigator said she liked it, but sent it up to her supervisor who said that there was no need to “drape” a patient during transport anymore and that MCH would need to be written a deficiency for the policy.
“It was OK before, but not now and so we asked for clarification because of the ‘anymore’ and we were told the new CMS recommendation is to transport with a mask on and a sheet that covers the patient up to the neck.” The new policy requires that hallways are cleared before COVID transports and that elevators are limited to one patient.
Tippin said MCH immediately implemented that change. During that same site visit, the CMS investigator also noted that some signage on the walls had been taken down to paint the wall and not yet replaced and also that one COVID page in the discharge packets for patients needed to be updated.
Tippin said the CMS visit was over in about 24 hours and ended with all issues resolved by the time the investigator left.
He added that CMS had 10 days to provide the report and that MCH had 10 days to respond, which was done by noon on Monday. Now, CMS has 90 days to return and inspect the changes. There were no fines or license suspensions, but MCH is on what he called a provisional status until the final inspection. He said the final outcome is essentially that CMS put them on a 90-day monitoring for deficiencies but added that those deficiencies were corrected before the inspector left.
He said discussions with other health care providers showed that many places were doing something similar to what MCH was doing while others came up with other ways to keep patients safe during transport. He said the complaint also gave MCH officials the opportunity to self-evaluate, although he also added that during two years of COVID that other patients had sometimes refused the plastic drape but that no one had complained.
“Wartime and pandemic medicine are not pretty … They (the plastic drapes) are effective, but we never intend to put anyone in harm’s way. We thought not only were we protecting the patient but their family and our staff and to make sure everyone was safe. … We thought we were doing the right thing. We should have done a better job.”
He said MCH officials learned they were not doing a good enough job communicating that to the mother of the patient.
“She was monitored the entire time and on oxygen. We have that documented, but our job is to do better and we have learned a lesson to be more sensitive to the patient and their family. … We have learned a big lesson; no matter how good we think our policy is, we need to pay attention.”
He also discussed the continuing threats that hospital staff members have received since the photo went viral on social media.
“Our staff took a massive amount of horrible threats … calling to tell us that they are going to come and shoot us in the parking lot or blow up the hospital.”
Tippin said those things are difficult to deal with for a staff that has spent almost two years dealing with COVID, but that they hope to move forward and continue providing quality healthcare in Odessa.
