Vaccine mandate prompts barely a ripple at BVRMC

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Buena Vista Regional Medical Center only lost two full-time employees due to a coronavirus vaccination mandate that took effect on Friday, a marginal number of departures that’s shared among UnityPoint affiliates in the health system’s Fort Dodge network. 

BVRMC spokeswoman Katie Schwint told The Storm Lake Times the hospital’s vaccination rate on Monday morning was 96% among a roster of more than 400. She acknowledged some employees are still “making decisions” and others are in the process of requesting “medical exemptions, religious exemptions or deferrals” that must be accompanied by a doctor’s note and approved by an administrative panel. 

Schwint noted the hospital does not expect disruptions to operations as a result of the mandate that took effect at 11:59 p.m. on Friday. BVRMC CEO Rob Colerick announced the mandate to employees in September.

“We have had (two) full-time employees that have chosen to leave our organization or not currently scheduled for future shifts due to the requirement,” Schwint wrote via email on Monday.  

BVRMC’s was the second mandate to take effect among Buena Vista County’s major employers; the first was UnityPoint Clinics, which shares a space with the hospital on the West Fifth Street campus. Vaccine-prompted layoffs were scant or non-existent among the health system’s affiliated clinics and county-owned hospitals in its Fort Dodge region, said Pocahontas Community Hospital CEO James Roetman, who provides updates on UnityPoint to the BVRMC board of trustees. 

UnityPoint representatives couldn’t be reached for comment on whether their vaccine mandates have had an impact to clinic staffing.

“For the vast majority of us, October 1 was really just another day,” said Roetman of the effective date of UnityPoint’s vaccine mandate. “UnityPoint, they’ve had some departures, but the number was fairly low.”

Roetman said hospital staffing in rural Iowa was an issue that’s dated back to the 1980s. Low reimbursement rates from the Center for Medicare and Medicaid Services and depopulation have slowly eroded traffic among Iowa’s critical access hospitals and have thus constrained the services they provide. Iowa Hospital Association CEO Kirk Norris told Iowa Watch in September 2019 the combined margin among the state’s critical access hospitals, or facilities with 25 beds or fewer, is -2.8%. A sustainable margin is around 2%. 

Roetman noted the five hospitals in the Fort Dodge region have been buoyed by federal assistance in three separate stimulus packages Congress passed since the coronavirus pandemic. 

The cost of staffing has outstripped whatever gains rural hospitals have posted over the long-term, Roetman argued. 

“Hospital staffing was a big problem before the pandemic. Those underlying factors continue to be a problem for us, the main one among them is there’s a lack of a workforce in Pocahontas County,” he said. 

All but one hospital in UnityPoint’s Fort Dodge region have imposed vaccine mandates with effective dates ranging from Nov. 1 to Dec. 1. Around 80% of county hospitals in Iowa have imposed mandates, according to a database compiled by the Iowa Hospital Association. The hospital in the Fort Dodge region that hasn’t imposed one, Humboldt County Memorial Hospital, is wrangling with federal guidance surrounding vaccine mandates for staff of its attached nursing home facility, he explained.

Roetman expects departures from Pocahontas to be minimal. The hospital’s vaccination rate as of Monday morning was around 85%; around 20 employees are “still weighing the information on both sides” or in the process of obtaining an exemption, he added.

“There was a discussion about it being a freedom issue; that went away pretty quickly after we showed through our own handbook that we require flu vaccines as a condition of employment,” Roetman said. “We haven’t lost anybody yet and we hope we won’t lose anybody.”

Vaccine mandates among hospitals are a prelude to a number that take effect among other healthcare providers and major employers by the end of the year. Interviews in recent weeks have showed little concern over staffing, except among nursing homes, whose vaccination rates have lagged behind those posted by area hospitals and Tyson Foods. 

A federal database of CMS reimbursement recipients shows an average of 60% of nursing home staff in Buena Vista, Cherokee and Pocahontas counties have been vaccinated. A federal vaccine requirement for nursing homes is expected to take effect Nov. 1. By contrast, Tyson Foods has reported over 90% of its Storm Lake campuses have received inoculations.

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