Some rural hospitals fear vaccine mandate will make labor shortage so bad that they'll have to close or cut back more

A nurse in a Louisiana Covid ward (AP photo by Gary Hebert)

Requiring all health-care workers to be vaccinated against the coronavirus could worsen chronic staffing shortages at rural hospitals, because rural areas have low vaccination rates and many health-care workers have yet to be vaccinated.

The latest look at this issue comes from Aallyah Wright of Stateline, who notes, "In the broadest sense, President Joe Biden’s vaccine requirement for the more than 17 million U.S. health care workers will alleviate the strain on all health centers and clinics by boosting the country’s overall vaccination rate. . . . But the story may be more complicated in rural America, where resistance to the vaccine remains strongest."

Wright quotes rural hospital leaders who worry that the mandate will make the labor shortage so bad in some hospitals that they will have to close. "Dr. Randy Tobler, CEO and director of women’s services at Scotland County Hospital in rural Memphis, Missouri, said his hospital will abide by Biden’s mandate, but some staff members have told him they will quit rather than get vaccinated."

Brock Slabach, chief operations officer for the National Rural Health Association, told Wright, “I've talked with administrators of hospitals that have estimated anywhere from 3 percent to as much as 20 percent of their workforce may have to quit their jobs if they're required to have the vaccine as a condition of their employment. In a rural hospital, that could be two, maybe three nurses, which could cripple their ability to meet the demands of patient care.”

The Centers for Medicare and Medicaid Services hasn’t said when workers will have to meet the requirement, and there are other reasons for uncertainty. "At least 22 states plus the District of Columbia announced that state health care workers—or, in some cases, all health care workers—would need to be vaccinated or regularly tested, according to the nonprofit National Academy for State Health Policy," Wright notes. "But six states—Arkansas, Georgia, Indiana, Montana, Tennessee and Texas—have approved laws or have executive orders from their governors prohibiting vaccine mandates as a condition for employment. Hospital leaders say the conflicting guidance makes it difficult to know how they should proceed, though experts assert that federal law will supersede any conflicting state law or executive order."

The uncertainty adds to the stress of the pandemic, now in its 20th month. Some hospitals have "cut back, delayed or eliminated services such as elective surgeries, labor and delivery, and other inpatient care," Wright notes. "Nurses and other health care employees have worked double shifts, and many rural hospitals have had to create makeshift intensive-care units."