On Nov. 5, the Centers for Medicare & Medicaid Services (CMS) issued an Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule (the Rule), adding vaccination requirements to the Conditions of Participation for numerous health care providers, including Medicare- and Medicaid-certified hospitals and critical access hospitals such as Cedar County Memorial Hospital (CCMH).  This Rule covers all staff members (except those working totally remotely); and under the Rule, staff members must receive a single-dose vaccine or the initial dose of a multi-dose vaccine by Sunday, Dec. 5. Staff who receive a multi-dose vaccine must receive all required doses no later than Jan. 4, 2022. The Rule allows for religious and medical exemptions through a defined process with specific criteria.  Medicare- and Medicaid-certified facilities are expected to comply with all regulatory requirements; and CMS has a variety of established enforcement remedies for those that do not comply, up to termination from the Medicare and Medicaid programs.  This Rule is having a significant negative impact on health care providers throughout the nation who are already struggling with a shortage of staff.

At the Nov. 17, meeting of the CCMH Board of Directors, the Board made the difficult decision to close its In Home Services program effective Nov. 30, and to provide notice to the Cedar County Commission of CCMH’s inability to provide public health services after Dec. 3, pursuant to the 1995 agreement between CCMH and the Commission, due to a lack of personnel to staff the Cedar County Health Department.  This is a direct result of the Rule.  In its letter to the Commission, CCMH requested that due to the time constraints, the Commission consider allowing for a shorter termination period than the ninety (90) days provided for in the agreement.

CCMH understands the hardship these actions place on county residents and wants to let residents know that efforts were made through contacts with the Missouri Hospital Association and the Missouri Department of Health and Senior Services to determine if there were options available for relief of the mandate for Cedar County Health Department staff.  However, it was confirmed that from a legal standpoint and at this moment in time the Rule would apply to Cedar County Health Department staff as employees of CCMH.  In the words of CCMH Board Vice President Marvin Manring, “If you don’t ask, the answer is always ‘no’.  We wanted to assure we covered the bases in this very unique circumstance, as we know the importance of these services to our community.”

CCMH appreciates the continued support of the Commission and will do all it can to make the transition smooth in whatever course the Commission decides to take.

All board members were present at the Nov. 17 meeting: President Michelle LaRoux, Julia Phillips, Judy Renn, Marvin Manring and David Bozarth.

In another issue the board was informed the several hospital staff members would self-terminate by the Dec. 15 deadline for covid vaccinations.

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