HCA Healthcare has opted against a COVID-19 vaccination mandate for its more than 275,000 employees, the for-profit hospital giant's finance chief said Thursday.
Chief financial officer Bill Rutherford made the disclosure during a virtual presentation at Morgan Stanley's 19th Annual Global Healthcare Conference. He said 186-hospital HCA "obviously" encourages the vaccinations, but is not mandating them.
"Those are ongoing discussions that our clinical leadership team coupled with our epidemiologists and our operating team will continue to look at," he said. "But that's not a position HCA has taken at this point."
The announcement came before President Joe Biden announced healthcare facilities receiving Medicare or Medicaid funds must have vaccine mandates. HCA said it will review the details and respond accordingly. The company said it follows guidance from the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration.
COVID-19 vaccination mandates are a hot-button issue, but that hasn't stopped dozens of not-for-profit health systems from implementing them across their workforces. The big for-profit hospital chains appear to be less eager to do so, however, and Tenet Healthcare and Universal Health Services did not disclose their stances when asked by Modern Healthcare on Thursday. Community Health Systems said it is not making the COVID-19 vaccine mandatory for employees.
About 41% of hospitals nationwide had some sort of employee vaccination mandate, or about 2,550 hospitals, as of Wednesday afternoon, according to the American Hospital Association, which supports vaccine mandates. The for-profit hospital trade group Federation of American Hospitals has urged healthcare workers to get vaccinated for COVID-19, but has not called on hospitals to mandate the vaccines.
Among those that have mandates are 91-hospital Trinity Health, a Michigan-based Catholic system that employs 117,000 people. California's Kaiser Permanente has now done the same for its more than 216,000 employees.
The big reason hospitals fear mandates is because they don't want to lose workers in an already tight labor market, Craig Laser, a clinical associate professor in Arizona State University's Master of Global Management in Healthcare Services program, wrote in an email.
"In a time when so many clinical disciplines, especially nursing, are facing critical staffing issues, it could be a balance between staffing and a mandate," he said.
Mandates could be especially tricky for the for-profit hospital chains because many of their locations are in Southern states with higher rates of vaccine hesitancy.
The fact that many health systems' staff are represented by labor unions adds another level of complexity, Laser noted. Healthcare unions are divided on whether to support vaccine mandates, with some holding that mandates should not supersede workers' rights.
Unions have loudly accused Nashville-based HCA of putting profits over safety during the pandemic. SEIU-United Healthcare Workers West even sued thehospital chain in August 2020 alleging the work environment at its hospital in Riverside, Calif. was unnecessarily dangerous for patients, visitors and the community because of inadequate personal protective equipment supply and other issues.
On Thursday, SEIU-UHW spokesperson Renée Saldaña wrote in an email that although the state of California requires hospital workers to be vaccinated if they don't have a medical or religious exemption, that's not the case in other states where HCA operates.
"HCA has put profits before safety throughout the pandemic, so it's not surprising to see them lagging behind the rest of the industry on vaccinations as well," she said.
An HCA spokesperson said all staff still must wear masks in hospitals, and frontline caregivers receive regular screening, testing and personal protective equipment.