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Montana facilities prepare for vaccine mandates, hospitalizations remain high

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Montana continued its downward trend in COVID cases over the last week, but hospitalizations and COVID-19 related deaths remain high.

On Monday, 351 Montanans were hospitalized with COVID-19 and over the last seven days 57 people died from COVID-19 related illness.

Over the weekend, six Yellowstone County residents between the ages of 50 and 80 died of COVID related illnesses.

During the last week, Montana has averaged 374 COVID patients hospitalized and 101.4 COVID patients hospitalized in ICUs daily. On Monday, 82% of ICU beds were full.

Over the last seven days, 57 Montanans died of COVID-19 related illness bringing the seven-day average to 10.1 deaths per day.

Golden Valley, Park and Treasure counties have the highest number of cases per 100,000 people in the state with 244 cases, 169 and 144 cases per 100,000 people respectively.

For the third consecutive week, 55% of eligible Montanans are fully vaccinated, according to the state dashboard.

On Monday, 112 patients were hospitalized at Billings Clinic and St. Vincent Healthcare. Of those, 34 were in the ICU and 21 were on ventilators. The majority of the COVID-positive inpatients were unvaccinated with 94 unvaccinated and 18 vaccinated.

Last week, the federal government released vaccination requirements for Americans who work at companies with 100 or more employees and for workers in health care facilities and home health care providers who receive funding through the Centers of Medicare and Medicaid Services (CMS).

Over the weekend, a federal appeals court halted the vaccination mandate for companies with more than 100 employees, which is regulated by the Occupational Safety and Health Administration.

As of Monday, there were no challenges to the CMS rule issued Thursday that requires all staff who get funding from the government health program to be at least partially vaccinated by Dec. 5, 2021.

The requirements will apply to about 76,000 providers and cover over 17 million health care workers across the country.

Facilities in Montana are starting to draft their policies that will ensure workers are fully vaccinated before providing care to patients by Jan. 4, 2022.

Non-compliance could result in funding being pulled from the facility.

Long-term care facilities in the state see the federal mandate as progress, as the last two months have forced units to restrict visitors and bar new residents due to positive COVID cases among staff.

Immanuel Lutheran Communities in Kalispell receives 90% of its funding from CMS, meaning without it the facility would be forced to close its 300-bed facility, according to CEO of Jason Cronk.

Cronk is in support of the mandate, saying vaccination requirements will result in a better living environment for his residents.

Unvaccinated staff have exacerbated staffing shortages as employees test positive for COVID or protocol for close contacts forces others to stay home until a negative test is produced.

“We’re doing less than best for our residents,” Cronk said in a interview with The Gazette in August. He added that residents are the ones who are isolated from family and friends when there is a positive case.

Staffing shortages are being felt in nursing homes throughout Montana, with 41.5% of facilities experiencing insufficient staff, according to AARP’s nursing home COVID-19 dashboard.

Between the labor shortages Cronk felt earlier this year and 40% of his employees unvaccinated, he was forced to limit admissions to the facility in August.

By November, staffing difficulties have eased slightly as more applications for certified nursing assistant positions have been rolling in.

Cronk expects some staff will leave the facility due to the vaccine requirement, but doesn’t expect the change to be significant.

“We’re cautiously optimistic,” Cronk said. “Some of our staff are still hesitant to get vaccinated, so we’re preparing for a mixed bag.”

CEO of St. John’s United David Trost has some concerns over the mandate, but sees it as action being made to protect vulnerable populations.

“It will be very challenging as (the mandate) mostly affects those who have already made choices not to yet get vaccinated,” Trost said. “I expect bumpy roads lay ahead.”

Billings Clinic’s policy team is working out the logistics of its vaccination requirements to align with the CMS deadlines, according to Chief Human Resources Officer Jonathan McDermott.

“We have to comply with the law,” McDermott said, adding that the federal rule supersedes House Bill 702 that makes requiring vaccination illegal in Montana.

The hospital receives over 51% of its funding through CMS, meaning “patient care would be unsustainable (if funding were to be pulled),” McDermott said.

As of Monday, over 65% of the Clinic's staff were fully vaccinated.


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