Following CHI Memorial's lead, more Chattanooga area hospitals are moving to require employee COVID-19 vaccinations

Staff Photo by Robin Rudd / Deborah Deal, chief nursing executive at Parkridge Health, gives Dr. Robert Magill his first COVID-19 vaccination at Parkridge Medical Center on Dec. 17, 2020.

Three months after CHI Memorial announced it would require workforce COVID-19 vaccinations, Chattanooga's other two major hospital systems are quietly moving ahead to do the same per a rule from the U.S. Centers for Medicare and Medicaid Services.

On Nov. 5, CMS issued a requirement that workers at health care providers participating in the Medicare and/or Medicaid programs - which is the majority of providers in the country - must receive their first COVID-19 vaccine dose by Dec. 6 and be fully vaccinated by Jan. 4. CMS providers are exempt from a new Tennessee law barring employers from mandating COVID-19 vaccination.

Staff, contractors and volunteers at a wide variety of providers - including hospitals, nursing homes, federally qualified health centers, rural health centers, home health agencies and outpatient rehab facilities - are all subject to the new rule. Exemptions are allowed for those who cannot receive vaccines due to a documented medical condition or sincerely held religious beliefs.

Though details of the CMS rule weren't published until November, the federal agency announced its intent to issue a rule requiring COVID-19 vaccinations for health care providers in September.

Some major health care industry employers in the Chattanooga region, including CHI Memorial and BlueCross BlueShield of Tennessee, began moving to compel workforce COVID-19 vaccinations around that same time.

All CHI Memorial workers who did not qualify for an exemption had to be fully vaccinated by Nov. 1 to keep their jobs.

While CHI Memorial officials were outspoken about that decision, Erlanger and Parkridge health systems did not implement COVID-19 vaccine requirements until the CMS rule was finalized and never formally announced they would comply. All three health systems already required employees to get a flu shot each year.

Parkridge spokesperson Jamie Lawson said in an email that "to date, Parkridge Health System has encouraged our colleagues to get vaccinated against COVID-19 and made vaccines readily available, but we have not mandated vaccination.

"To comply with recently issued federal health care regulations through CMS that mandates vaccines as a criteria to serve Medicare and Medicaid patients, we are now requiring our colleagues to be fully vaccinated for COVID-19 by Jan. 4," Lawson said. "The majority of Parkridge Health colleagues have already been fully vaccinated. We are working with our colleagues to assist those that have not yet received the vaccine."

Erlanger CEO Dr. Will Jackson called the new rule "a heavy lift given the timeline" during the health system's most recent public board meeting. Erlanger informed staff last week that it would comply with the mandate, and the administration has received "a lot" of inquiries as a result, Jackson said.

"[There's] a very difficult operating environment around that, but we're going to make sure we meet it," he said.

Neither Parkridge nor Erlanger shared data on current employee COVID-19 vaccination rates for this story. CHI Memorial officials estimated that less than 1% of employees resigned as a result of its vaccine mandate.

The CMS rule that applies to health care providers is separate from the Occupational Safety and Health Administration's rule ordering employers with 100 or more workers to require employees to get vaccinated for COVID-19 or undergo weekly testing. Enforcement of the OSHA rule is currently paused following a federal appeals court order.

Erlanger is Chattanooga's largest employer, with just more than 6,300 full- and part-time workers as of June 30. CHI Memorial has about 4,600 associates and more than 600 affiliated physicians across Southeast Tennessee, North Georgia and Northwest Alabama, according to a news release. Parkridge has about 1,450 full- and part-time employees, according to the Chattanooga Area Chamber of Commerce's 2021 major employer list.

Although they were among the first to gain access to COVID-19 vaccines, 30% of staff in more than 2,000 hospitals nationwide remained unvaccinated as of Sept. 15, according to a U.S. Centers for Disease Control and Prevention report published Wednesday.

It's unclear how much the hospital vaccine requirements could exacerbate staffing shortages. While polling suggests few people actually leave jobs over vaccine requirements, COVID-19 vaccine resistance varies widely and is higher in more rural and conservative regions of the country.

Contact Elizabeth Fite at or follow her on Twitter @ecfite.