Healthcare facilities must have a fully vaccinated workforce by Jan. 4, 2022, under the CMS’ mandate that the states are contesting. The CMS mandate does not include a testing option like the OSHA rule and has been predicted to be on firmer legal ground.

The number of workers who will actually leave the field won’t be clear until the deadline for vaccination has passed. About 30% of healthcare workers in over 2,000 hospitals were unvaccinated as of mid-September, according to an analysis from the Centers for Disease Control and Prevention.

The CMS has argued that the mandate will have a positive impact on staffing since employees will use less sick leave and any job openings could attract new workers into the industry.

Healthcare facilities shouldn’t hold their breath on the rule being blocked or altered. The penalty for noncompliance is termination from Medicare and Medicaid programs, and “gambling on your main source of revenue” is “a very dangerous game to play,” said Kristin Ahr, a partner at Nelson Mullins Riley & Scarborough LLP who practices employment litigation.