JOHNSON CITY, Tenn. (WJHL) – The number of Ballad Health employees not yet vaccinated against COVID-19 had dropped sharply in the two weeks leading to Friday’s deadline for staff members to have at least one dose — but dozens still risked termination at that point.

The 13,000-employee hospital system falls under a Feb. 28 deadline for staff to be fully vaccinated and had set an internal deadline of Feb. 11 for first dose compliance. Someone vaccinated Friday would be due for their second dose March 4, several days after the CMS deadline.

News Channel 11 last spoke to Ballad about employee vaccination totals Jan. 27, when CEO Alan Levine said the system had “just under 1,000 employees staff who have not taken the vaccine and who have not sought an exemption.”

Several efforts since Thursday to reach someone at Ballad who can provide updated numbers have been unsuccessful, but the Bristol Herald-Courier cited Chief Operating Officer Eric Deaton Friday as saying that number had declined to just over 130.

The number of COVID vaccine holdouts among Ballad Health staff has dropped quickly in recent weeks as a Feb. 11 deadline approached.

Levine has approached the vaccine battle from a couple of fronts. He’s consistently touted its effectiveness and safety while insisting the mandate could do more harm than good in conservative and rural areas where staffing is already short.

During the Jan. 27 news conference, Levine said management staff, particularly direct supervisors, would “keep trying and leaning into it” in efforts to convince skeptical employees to get vaccinated.

Whether it’s been as a result of those efforts or simply the prospect of actually losing a job, the past couple of weeks has seen many employees move off the fence and either get their first shots or gain a religious or medical exemption.

The final fate of CMS’s mandate for health care providers who get revenue from Medicare or Medicaid remains uncertain. By a 5-4 vote, the Supreme Court ruled a month ago against an injunction that was preventing the mandate’s enforcement in a number of states. If the justices stick to their positions when the case is tried on its merits, the mandate would remain.

In the meantime, Ballad’s board of directors and top leadership must decide how to proceed with respect to whatever number of employees had insisted on defying the mandate through the weekend.

A Centers for Medicare and Medicaid Services (CMS) FAQ says staff at all affected systems must have received at least one vaccine dose by the end of what’s called Phase 1 “prior to staff providing any care, treatment, or other services for the facility and/or its patients.”

That language does not say those staff members must be fired.

According to CMS, Phase 1 for Tennessee and 24 other states was actually Jan. 27, but Ballad went by the deadline for states that were under the injunction that was lifted by the Supreme Court.

As far as enforcement by CMS, Levine said on Jan. 27 that he expected the agency to be reasonable as it enforced the mandate.

“But I do believe that if they don’t see us actively trying to comply, then the penalties could be pretty severe when you’re in violation of the conditions of participation.

“I don’t want to speculate about what will happen on February 12th but as the rule reads now, they’re not permitted to work once that deadline has come and gone.”