JOHNSON CITY, Tenn. (WJHL) – Hundreds of Ballad Health employees got a first dose of COVID-19 vaccine this month as a Feb. 11 deadline loomed, but 63 who didn’t are unable to work due to a federal mandate.

Ballad CEO and President Alan Levine provided details in an all-staff email Wednesday morning to the system’s 13,000-odd employees. Another 250 workers are unvaccinated but currently have deferrals due to having or recently having the virus, so the number unable to work due to the Centers for Medicare and Medicaid Services (CMS) mandate could increase.

An additional 1,700 medical and religious exemption requests were approved by Ballad, which represents about 13% of staff members.

Hundreds of Ballad Health employees have gotten COVID vaccinations ahead of a mandated deadline, leaving the system with low numbers at risk of termination and only 63 currently unable to work. (WJHL Photo)

“Probably more than I was originally expecting,” Levine said in a press briefing on Wednesday afternoon, “but we’ve been consistent – very clear from the beginning. We said we were going to be very liberal. We’re not in a position to question someone’s religious beliefs.”

A CMS FAQ on the mandate says systems can establish their own processes for requests and granting of religious exemptions. That FAQ says “exemptions could be appropriate in certain limited circumstances, but no exemption should be provided to any staff for whom it is not legally required or who requests an exemption solely to avoid vaccination.”

CMS says systems should refer to the federal Equal Employment Opportunity Commission’s Compliance Manual on Religious Discrimination for more information on exemptions. It also provides some guidance on where systems can get more details on medical exemptions.

The Ballad details came near the end of an email that also outlined numerous efforts by the system to help workers with child care and salary increases, bonuses and perks such as tuition reimbursement. Levine has made no secret of Ballad’s struggles to recruit and retain enough staff, both clinical and otherwise, both before and during the pandemic.

More vax mandate details

Ahead of a 4 p.m. news conference and a day after Ballad’s board of directors met to discuss the mandate, Levine provided several additional details about the passing of the initial “Phase 1” deadline for the mandate. Health care providers that are reimbursed by CMS, which includes most physician practices as well, must comply with the mandate to continue receiving reimbursement, which comprises a large portion of Ballad’s revenue.

Levine noted that the system had more than 1,000 employees who weren’t vaccinated and hadn’t sought exemptions just a few weeks ago. “This obviously was of great concern to us as we strive to continue serving the needs of our region,” Levine wrote today.

On Jan. 27, he said the system would continue “leaning into” efforts to convince staff to get vaccinated. The system also announced a special bonus, part of which would be payable several months from now.

“I applaud the work of our team members, supervisors and managers who, each day, methodically worked to help team members make the best decisions for themselves, with the ultimate goal to sustain our staffing, and mitigate additional damage through loss of more staff,” Levine wrote Wednesday.

Of the 63 whom CMS now requires Ballad to put on inactive status for 90 days, 45 are direct clinical employees. Levine told News Channel 11 Tuesday the system has 600 nursing vacancies, which he said made “the idea of chasing off a single nurse unnerving.”

“It’s hard to find people right now,” Levine said. “Our key is to do everything we can to lean on retention so we don’t lose more people while at the same time, we do everything we can to fill those position in the near term.”

During the 90-day furlough, employees can complete the vaccination process and return to work, which in the case of the Johnson & Johnson vaccine would be immediate. They can also request termination or voluntarily resign, in which case they would be eligible for rehire at a future date.

Employees who don’t act on either of those options “will be terminated involuntarily in accordance with policy,” the email says.

“I will pray for the people who did not do it,” Levine said. “I hope they find alternatives for employment. There’s plenty of employment out there. But I’d sure like for them to come back. We could use them and use their expertise.”

Hundreds of employees beyond those 63 still could lose their jobs. About 250 have deferrals. If they tested positive for COVID-19, they’ll have to get the first shot within the next few weeks. If they received monoclonal antibody treatments, a 90-day delay from the treatment date is in place before they can get the first dose.

Ballad will notify those staffers of their upcoming expiration date for deferral and provide information about the next steps and deadline requirements.

The 450 or so employees who’ve gotten a first shot of the Pfizer or Moderna vaccines will need to be fully vaccinated by March 11 or they too will be shifted to inactive status.

While he’s consistently encouraged employees to get vaccinated, Levine has also consistently expressed opposition to a mandate. He said Tuesday he’s concerned about how the policy is being rolled out, though he does expect CMS to enforce it with some concern for the staffing struggles systems are facing.