ASC execs split on vaccine mandate amid staffing woes

CMS plans to mandate COVID-19 vaccines for all staff at ASCs and hospitals as a condition for participating in Medicare, which may place extra strain on many surgery centers already facing a staffing crisis.

"CMS announcing the COVID-19 vaccine mandate to include ASCs impacts us significantly," said Brock Kreienbrink, RN, MSN, administrator and director of nursing at Outpatient Surgery Center of Central Florida in Ocala. "We are in a market with an extreme labor shortage, and this will just add even more stress to our labor shortage."

Some of the staff at Outpatient Surgery Center of Central Florida have been vaccinated while others have had COVID-19, tested positive for antibodies and do not want to get the vaccine. He said he also has some employees, who are not at high risk for COVID-19, say they are opting to not receive the vaccine because of concerns about potential long-term effects. The vaccine has been approved by the FDA.

"Personally, I cannot and will not force an employee to receive any vaccine they do not want," Mr. Kreienbrink said. "This is a personal health decision and should not be mandated. This CMS mandate will be for the courts to decide."

Staffing is tight at ASCs across the U.S., which are competing with hospitals that offer large signing bonuses to nurses and staff members to fill needed roles. Nurses exited healthcare at a high rate during the pandemic, and now their services come at a premium.

"At a time where staffing our center is crucial, this will be yet another challenge to overcome in order to continue to provide the greatest possible care to our patients," said Brandon Hollis, administrator of Bone and Joint Institute of Tennessee Surgery Center in Franklin.

ASCs may also see a split between the physicians and staff when it comes to vaccinations. Joseph Imbriglia, MD, of Western Pennsylvania Surgery Center, said all the physicians at his center are vaccinated, but about half of the surgical techs are not. The center performs around 6,700 surgeries per year and has not experienced adverse events related to COVID-19.

"A vaccine mandate would have a very negative impact on our ability to deliver efficient and timely care," Dr. Imbriglia said. "I, personally, am against a vaccine mandate."

Jason Richardson, CEO of Gastroenterology of the Rockies in Louisville, Colo., also said the vaccine requirements will add pressure to the staffing crisis for ASCs but thinks it will have less of an effect on surgery centers than on hospitals.

"At the end of the day, I'd prefer that health-related personnel do get the vaccine and embrace their responsibility to do what they can to keep our patients, communities and coworkers as safe as possible," he said. "The vaccine is just one important component to controlling the pandemic."

Other ASCs see few stumbling blocks from the mandates. Catherine Retzbach, RN, BSN, administrator of Memorial Ambulatory Surgery Center in Holly, N.J., said her center is owned by a health system that already mandated vaccinations for all staff. Smaller surgery centers, such as Sinus Center of Idaho and Sinus Surgery Center Idaho, may already have all staff voluntarily vaccinated.

The mandate at centers with nearly 100 percent vaccination rates may push the others to get the shot as well.

"[The mandate] would have minimal impact operationally on our center, as most of the staff and all of the surgeons are vaccinated," said Craig Gold, PsyD, administrator of Virginia Center for Eye Surgery. "Our governing board decided last month to mandate vaccines for all, absent a valid medical exemption. As a result, the two hesitant team members who work here finally capitulated and have received their first shot and will be getting their second."

Allen Chiou, MD, administrator of Unicare Surgery Center in Anaheim, Calif., said all staff at his center voluntarily got the vaccine but knows other centers may not have the same results.

"I can see this being a contentious issue since, unfortunately, this issue has adopted political undertones," he said. "The important thing is that ASCs focus on adopting systemwide policies that keep patients as safe as possible. It is important not to let our guard down even if our staff and patients are all vaccinated, since vaccines are not 100 percent effective."

Beth Wood, administrator of Endoscopic Procedure Center in New York, also has mandated that staff get vaccinated. "All of our staff are vaccinated," she said. "If not, they would have to resign."

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