Preparing hospital staff through vaccinations

DAYTON–Columbia County Health System CEO Shane McGuire and Chief Human Resources Officer Laura Stevens discussed with Board members the recent COVID-19 vaccination mandate for healthcare employees at the August meeting, requiring them to be fully vaccinated by October 18 or be terminated.

McGuire reported that since the mandate 12 employee vaccinations have been administered and 15 more were scheduled during an employee vaccine clinic offered on August 31. Stevens reported just over half of CCHS employees had been previously vaccinated before the mandate was issued. She said employee reaction to the mandate has been sometimes based on misinformation and some "do not believe in being vaccinated and so there's frustration and anger and some that are threatening to resign and some that are moving along to be vaccinated and others that we found that misinformation was so bad but when we were able to provide good solid information, they were willing to get vaccinated."

McGuire added that people may not be necessarily against vaccinations, but what they wanted was more time. "When you get a mandate and it forces you to school-up and you start researching and then you jump into the fray of all that's out there–good, bad, accurate and sometimes misleading, it's been challenging and it's such a short window of time." Said McGuire.

Stevens observed people in this community don't feel the threat of COVID because locally "we haven't seen the devastation; we've been pretty protected". She went on to speculate that people feel more threatened by possible side effects of the vaccination than by COVID.

Board member Jim Kime asked about employees who have no intention of getting the vaccine and have made the position known. Stevens responded and that she and McGuire have discussed it and found that sometimes people have an initial emotional response against being forced to get the vaccination but that in time, they soften and sometimes with education, change their minds. Some will not change their minds and will resign. Kime pressed if replacements are being pursued. Stevens said they are posting for positions that they know are or will be vacated and are beginning to post for those that will be needed.

McGuire also answered, "We continue to meet with departments and staff regarding this new requirement" and if some have made their position known that they will not take the vaccination and are not on the list to receive the shot, human resources will be looking to fill their position. McGuire said, Kime later questioned CFO Matt Minor in reference to salaries already being over budget by just over $100k about whether they expect to remain over budget because of the COVID situation. Minor replied affirmatively for in the short term and that the CCHS salary budget has already been impacted by COVID which contributes to the current overage partly due to "shift incentives for clinical staff" to replace the high cost of contracting for traveling medical professionals.

Also, according to the financial report, "Employee Benefits were $73k over budget with dividend payments in the amounts of $9,781 and $53,242 for unemployment and worker's compensations, respectively, were accrued in June. During budgeting we anticipated a larger worker's compensation dividend. Purchased Services in July were $202k higher than budget. This is largely due to the ongoing healthcare staffing shortage, which is effecting the entire industry." Minor added, "We are still working on 2020 Medicare rates and even since we've prepared that initial interim cost report, our cost, our expense per day, Medicare will meet that."

Minor said they may submit another interim report for July's costs or wait until they get through August before it's due at the latest in October to get the rates up. Even though the cash on hand isn't negative, McGuire said that waiting on Medicare settlements does impact the amount of cash flow. "We've got a lot pressure on our cost of operations." Minor pointed out that much of that pressure is because of increased costs of the pandemic for which new programs offering funds are coming out regularly to help cover those expenses.

New Board member Barb Miller asked if those terminated due to not adhering to the vaccination requirement would be eligible for unemployment. McGuire responded that initially the Governor said they would be, but now they are told it would depend on individual circumstances. Stevens thought most likely terminated employees would not be eligible unless exemption accommodations weren't offered based on what information she's been provided.

McGuire also provided some statistics for hospitalizations in the State saying acute care staffed beds were just over 87% occupied with almost 17% for COVID patients and 85% of the ICU is occupied with 30% for COVID. He specified higher acute care hospitalizations numbers for the East side of the State at 91% with 13.5% being for acute care COVID patients and ICU hospitalization at almost 84% with 19% being for COVID illness. He clarified staffed beds are more of an issue than actual beds available.

Staff contracting COVID and taking leave impacts hospital staffing and being able to fill available beds which presents a challenge, McGuire says. With limited staffed beds available CCHS has had issues in transferring patients to other facilities to receive appropriate care and instead of delaying treatment because of waiting for a bed, CCHS staff are choosing to admit patients and care for them locally.

McGuire has chosen to work with the Washington Medical Coordination Center to help navigate situations where finding a facility that has space for patients who need to be transferred for specialty care can prove difficult.

At present, the County has 31 active COVID cases with a history of 22 hospitalizations and six deaths since the pandemic began. COVID cases have been up around 20-30 cases over the last month which is the highest sustained number of cases the County has seen. As a result, CCHS announced on August 27 that residents of Booker Rest Home is closed for visitors until further notice.