HHS orders Catholic hospital to snuff out chapel candle or lose its accreditation

candle HHS has ordered the Catholic hospital to extinguish the tabernacle candle (pictured) and its chapel. | Saint Francis Health Systems

A Catholic hospital system in Oklahoma is contesting federal officials’ demand that it must extinguish an enclosed tabernacle candle in its chapel or lose accreditation and its ability to serve needy patients.

The Centers for Medicare and Medicaid Services, a federal agency under the Department of Health and Human Services (HHS), ordered Saint Francis Health System in Oklahoma to snuff out the candle after one of its contractors responsible for accrediting hospitals deemed that it represented a fire hazard.

“We’re being asked to choose between serving those in need and worshiping God in the chapel, but they go hand in hand,” Barry Steichen, the executive vice president and chief operating officer of Saint Francis Health System, said in a May 3 statement. “Our work depends upon our faith in the living God, and the sanctuary candle represents this to us.”

Saint Francis Health System has five hospitals in eastern Oklahoma. It treats almost 400,000 patients per year and has provided over $650 million in free medical care over the last five years.

Lori Windham, vice president and senior counsel at the Becket religious liberty legal group, is representing the health system alongside the law firm Yetter Coleman LLP.

“The government’s demand is absurd and unlawful — it is targeting Saint Francis’ sincere beliefs without any good reason,” she said May 3.

Windham said inspectors wrongly cited a hospital system for its chapel candle and federal regulators then wrongly denied a reasonable accommodation request. In a May 2 letter, she said if a waiver was not granted, attorneys would seek a court order allowing the tabernacle candle to remain.

The health system’s accreditation body, The Joint Commission, in February cited Saint Francis Hospital South in Tulsa for its chapel tabernacle candle on the grounds it was deficient under fire safety standards. The Centers for Medicare and Medicaid Services (CMS) under the U.S. Department of Health and Human Services then rejected the health system’s appeal for a reasonable accommodation.

If the health system does not comply with the citation, the government will revoke its ability to serve elderly, disabled, and low-income patients through Medicare, Medicaid, and the Children’s Health Insurance Program, Windham’s letter to CMS said.

Windham said the citation is inconsistent with the relevant fire safety rules, the federal Religious Freedom Restoration Act, and the First Amendment of the U.S. Constitution. CMS has “inexplicably failed to apply a separate ‘unreasonable hardship’ exception from its (incorrect) code interpretation,” she said.

“For 15 years, that flame has burned without problem or concern in Saint Francis Hospital South in Tulsa; and for 63 years, the eternal flame has burned at Saint Francis Hospital Yale Campus, the largest hospital in the state of Oklahoma, without problem or concern,” her letter continued. “From the moment Saint Francis opened its doors in 1960, this flame has been maintained without interruption.”

“Saint Francis’ sacramental candles are an exercise of religion,” said Windham’s letter. She cited Catholic canon law and the fifth chapter of the General Instruction on the Roman Missal, which addresses tabernacle candles.

The general instruction, approved by the U.S. bishops and the Vatican, says: “In accordance with traditional custom, near the tabernacle a special lamp, fueled by oil or wax, should shine permanently to indicate the presence of Christ and honor it.”

According to Windham, the hospital candle is “encased in a thick glass globe, which is itself encased in a second glass globe, covered by a bronze top that fits over the second globe.” This globe rests in a bronze holder affixed to the chapel wall. There are fire extinguishing sprinkler heads around the candle and the local fire marshal has long approved it.

During a Feb. 21 inspection, Windham recounted, a surveyor from The Joint Commission at Saint Francis Hospital South in Tulsa “expressly asked to go to the chapel to see if there was a living flame.” The surveyor observed to hospital personnel that “other Catholic hospitals had complied and extinguished the living flame at their chapels, substituting it with an electric light.”

Windham objected that the surveyor rated the enclosed flame as a “moderate” threat and cited the hospital for violating the CMS Life Safety Code Requirements. While federal standards do classify chapel candles as “flame-producing equipment,” these are only barred within one foot of a nasal cannula, a device to provide supplemental oxygen. The hospital candle is never near such a device. The relevant codes and standards of the National Fire Protection Association expressly permit sanctuary candles.

The chapel’s candle has never been an issue in previous inspections. Wyndham said that since the citation the hospital system has asked for a waiver four separate times. CMS also permits open flames in kitchen stoves and ovens, gas dryers in the laundry room, flames in gas water heaters, and welding for construction purposes, she noted.

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“Saint Francis’ rights are so clearly established that continued violations will result in not just a court order, but personal liability for the individuals involved in the decision,” Windham said.

Late on Wednesday a CMS spokesperson told CNA it is “aware of a safety finding involving a fire risk,  made by an independent accrediting organization, issued to a hospital in Oklahoma.” 

“CMS is working with the hospital’s accrediting organization to develop options to mitigate the potential fire risk and remove the safety finding.”

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