Staff-strapped hospital has approved 160 religious exemptions to COVID shot mandate

A crowd fills the street outside of Montrose Memorial Hospital (now Montrose Regional Health) in August in support of staff members pleading with the board of directors not to implement a COVID vaccine mandate at the facility. The state soon after made that requirement, but allowed for religious and medical exemptions. Since then, 160 MHR employees received a religious/sincerely held belief exemption and 20 received a medical one. (Montrose Daily Press/file photo)

One-hundred-sixty Montrose Regional Health employees have been granted exemptions to the COVID-19 vaccine mandate on religious grounds/sincerely held beliefs. Another 20 have received medical exemptions.

All met the hospital’s requirements for the exemptions, CEO Jeff Mengenhausen said — and for Montrose Regional, it’s a balancing act between its support of vaccinations and the desperate need to retain staff amid a surge in a virus that since 2020 has killed an estimated 800,000 Americans.

According to the Colorado Department of Public Health and Environment, 131 Montrose County residents have died of COVID since March 2020.

“It’s a very polarizing issue as we look at it,” Mengenhausen said Friday, Dec. 17. “If I had 160 people quit because of the mandate, it would be really hard to keep the beds open during this COVID surge. It would only make things worse.

“We highly support the vaccine and the booster, but we also highly support our caregivers and value both.”

The State Board of Health on Aug. 30 required people currently employed in hospitals to be vaccinated against COVID, or to be tested regularly.

Prior to the state board of health action, dozens of staffers at Montrose Regional (then called Montrose Memorial Hospital) spoke out at the hospital’s board of directors meeting, protesting any mandate and saying it would spark walk-outs.

After state and federal requirements largely took the decision out of the board’s hands, the hospital estimated that it lost 10 employees over the shot. Mengenhausen said on Friday that an estimated two more have left since then, presumably over the vaccine.

About 720 employees remain. Of these, seven had missed work time because of COVID in the past week; their vaccination status was not available.

“We’ve actually seen a pretty significant decrease in COVID sickness of our employees. The majority of COVID is community-spread, not hospital. We are fully masked at the hospital and they all wear the appropriate PPE (personal protective equipment) when taking care of COVID-positive patients,” the CEO said.

The hospital still requires mask use and maintains its sanitation policies, as well as limits visitors and screens those who come through the doors.

‘Nebulous’

The code of regulations for the CPHE’s Health Facilities and Emergency Medical Services Division required hospitals to, by the end of October, develop and implement policies to ensure all employees were vaccinated.

These regulations require the facilities to provide proof of immunization of employees, or medical exemptions signed by a doctor, physician assistant, advanced practice nurse or certified nurse midwife who is state-licensed — or “documentation of a religious exemption, as defined by facility policy.”

The medical exemption is “pretty straightforward,” said Mengenhausen.

“That’s if you’re having an allergic reaction, different things like that. For the religious, strongly held beliefs, we worked with our employment law attorney.”

With the attorney’s advice, hospital leadership came up with criteria for approving or denying these types of exemptions based on the state mandate, he said.

“If they hit those aspects, we would grant it from that standpoint,” Mengenhausen said.

When asked about a copy of the policy, Mengenhausen said he did not know if it was considered a public document.

He said he expects a mixed reaction about the number of exemptions to vaccines requirements at the facility.

“Some people in our area are going to be happy we have that many exemptions and some are going to be upset we have that many exemptions. It’s distracting us from taking care of our communities and patients.”

Montrose Regional Health Board of Directors President Kjersten Davis said that although it has since improved, the state’s guidance was at first “fuzzy” and when it comes to exemptions, is nebulous.

“We’ve been trying to walk a fine line that we support the vaccine, but recognize that we need health care providers desperately,” she said. “We’re walking that fine line of trying to encourage and promote the vaccine, but also respect our employees and their personal beliefs and desires in order to keep employees.”

In addition to regular employees, Mengenhausen said Montrose Regional is having to use between 13 and 15 traveling nurses and respiratory therapists. These are contract providers who work a stint here short-term to help with the staffing crunch.

The COVID vaccine is not the only one Colorado hospital employees are required to have; they must also get a flu shot. MRH hasn’t seen comparable vaccine exemptions sought for the influenza vaccines. Mengenhausen said historically, that vaccination rate stands near 93%.

Strained resources, strained workersThe hospital did see a slight dip in COVID patient numbers within the last week or so, Mengenhausen said. On Friday, MRH was caring for nine COVID-positive patients, two of whom were on ventilators, he said.

“This is some of the lowest numbers in three months. We’ve been averaging around 18 or 19, with about five peopled vented.”

CDPHE data shows 10 days of “declining or stable hospitalizations” in Montrose County.

Although the hospital’s beds were freeing up a little, slightly reducing staff burden, patient transfers continue at a high rate.

“We’re getting patients from other surrounding communities as well. Unfortunately, the ICU will continue to be full for the next six months,” Mengenhausen said.

“As we see a slowdown in COVID, other areas may see a spike. When they’re (hospitals that have accepted Montrose transfers) having their surge or bed shortage, we’re going to return the favor and take their patients as well. It’s a statewide issue.”

Mengenhausen reiterated that the hospital’s leadership strongly urges people to get the vaccine — 95% of COVID patients who end up on ventilators were not vaccinated, he said.

“It will not stop you from getting COVID, but it will help you from going on the vent and dying,” the CEO said, taking note of the omicron variant that is gaining steam. The variant could sicken more people, driving another surge, he said.

“I think we’re always at a high level of concern,” Davis said. “I think we will be until we can get back to whatever the new normal is going to be.”

The pandemic continues taxing resources.

“It’s been really tough on the caregivers and the providers. We’re having patients in the hospital from 15, 20, 25, 30 days,” Mengenhausen said. “One of the problems with that is, if you’re on Medicare, we only get paid for six days (or in some cases, 11). The rest are on us. We have to eat that cost.”

Those on private pay may be eligible for hospital charity programs.

Medicare and Medicaid recipients have long made up the bulk of MRH’s patient load, so revenue-generators like elective surgeries important for the bottom line.

Although the hospital is not suspending elective surgeries like it had to for a time in 2020, it has rescheduled several because of capacity issues.

“We’ve had to slow down surgeries and be very selective on what type we’re doing if the hospital is full,” Mengenhausen said.

The toll on caregivers is not limited to overwork. They also bear a heavy emotional load when they lose patients.

“It’s been rough that’s what nurses and providers struggle with. They join health care to take care of people and make them better,” the CEO said.

“This virus is going the other way. It is really hard emotionally when you take care of someone for 25 days and they end up dying. … That’s really hard.”

Katharhynn Heidelberg is the Montrose Daily Press assistant editor and senior writer. Follow her on Twitter, @kathMDP.

Katharhynn Heidelberg is the Montrose Daily Press assistant editor and senior writer. Follow her on Twitter, @kathMDP.

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