HospitalInspections.org

Based on document review and interview, it was determined that for 3 of 28 COVID vaccination exempt personnel (Pharmacy Technician/E #6, Ultrasound Technician/E #7, and Patient Advocate/E #8), the Hospital failed to ensure the process for the implementation of additional precautions, intended to mitigate the transmission and spread of COVID-19, for all staff who are not fully vaccinated for COVID-19.

Findings include:

1. On 6/8/2022, the Hospital's policy titled, "COVID 19 Vaccination Contingency Plan" dated 2/16/2022, was reviewed. The policy required, "...Persons...who are unable to receive the COVID 19 vaccination due to an approved Medical or Religious exemption...shall be subject to the following contingencies...A. Shall undergo weekly COVID PCR testing with those results securely documented by Corporate Health or have attestations provided to [Hospital name] by the provider..."

2. On 6/8/2022, the Hospital's personnel COVID vaccination log (February 2022 - June 6, 2022) was reviewed. The log showed the following:
-A Pharmacy Technician (E #6) had a religious exemption for the COVID 19 vaccination. E #6's last weekly COVID test was the week of May 2, 2022. E #6's work schedule showed that E #6 worked 21 days from May 9, 2022 - June 7, 2022.
-An Ultrasound Technician ( E #7) had a religious exemption for the COVID 19 vaccination. E #7's last weekly COVID test was the week of April 25, 2022. E #7's work schedule showed that E #7 worked 18 days from May 2, 2022 - June 2, 2022.
-A Patient Advocate (E #8) had a religious exemption for COVID 19 vaccination. E #8's last weekly COVID test was the week of May 16, 2022. E #8's work schedule showed that E #8 worked 5 days from May 23, 2022 - June 3, 2022.

3. On 6/8//2022 at 10:30 AM, an interview was conducted with the Assistant Chief Executive Officer (E #2). E #2 stated that the personnel that have COVID 19 vacciantion exemption should have weekly COVID testing.