If there was ever a need to get out of, or around, a certain restriction, you could count on my former college roommate Cullen to figure it out.
Take, for example, the time he got in trouble for using his oversized car to repeatedly push a Dumpster behind a fellow classmate’s parked car, usually after some fun at a bar. The other guy was a jerk who probably deserved worse, and nobody ever got hurt. But eventually, campus security found out what was happening.
Enter the dean of students. He made a deal not to suspend, expel or otherwise punish Cullen as long as he surrendered his car keys for a month. Deal, said Cullen, who then proceeded to give his second set of car keys to one of our good friends. That friend, in turn, let Cullen drive his car.
About 10 days later, the day of reckoning came when Cullen was called to the dean’s office again. Security had documented his car being moved at least seven times. How could you not uphold your end of this sweetheart deal, the incredulous dean asked, part angry, part saddened.
Cullen assured him that he was in compliance with terms of the agreement and hadn’t driven his car. Fighting fiercely to suppress a grin, he freely explained the workaround.
And with that, the dean opened his desk drawer, tossed Cullen’s car keys back at him and with head down, barked, “Get out!” No further action was taken, not even the completion of the original 30-day penalty.
I’m betting there are more than a few long-term care Cullens either emerging or being made these days. If nothing else, this past week has shown us that providers have a strong interest in reading about compliance, exemptions and workarounds for the federal COVID-19 vaccine mandate.
The Supreme Court seconded the notion that healthcare providers should “at least do no harm,” as Chief Justice John Roberts so eloquently put it at a Jan. 7 hearing. So now it’s time to get on with making nursing homes as safe as possible during historically dangerous times. A million excess deaths is nothing to sneeze at, most people would agree. That’s the number that experts assigned this week to the overall carnage of the pandemic.
So Feb. 28 and March 15 will mark the dates that second, or final, shots need to be taken to qualify staff members as fully vaccinated. Unless.
Unless there is a medical or religious exemption in place. Or unless non-vaccinated workers are situated out of harm’s (patients’) way. Or unless some other arrangements can be made.
One provider, who shall remain nameless, wrote me that exemptions — which are granted locally — are the only thing keeping a significant number of his employees on the job. While the number of properly vaccinated employees has continued to rise since the Centers for Medicare & Medicaid Services announced its mandate Nov. 4, so has the number of people seeking, and receiving, exemptions.
Even CMS has allowed wiggle room for compliance in several ways. Get your staff up to 80% vaccinated and have a plan to get to 100%? You get another 60 days to comply. And a lot can happen in 60 days, as we, especially the lawyers among us, all know.
Even then, federal regulators have repeatedly impressed that heads will not roll at the first sign of non-compliance. Or the second. On the contrary. An assistive, teaching environment has been promised to all who want to observe best healthcare practices and not rely just on a “dedicated, compassionate, shows up” qualification.
Put another way, and as my old roomie Cullen reminded that dean so well: Where there’s a will, there’s a way.
The clever ones always figure out a way. Let’s all remember that.
James M. Berklan is McKnight’s Long-Term Care News Executive Editor.
Opinions expressed in McKnight’s columns are not necessarily those of McKnight’s.
