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COVID outbreak sidelines JCMC cardiovascular surgery staff

Ballad Health on Monday reported that a “significant majority” of its cardiovascular surgery department staff at Johnson City Medical Center have tested positive for COVID-19, which will keep them out of work until they are cleared to return.

As a result, patients requiring emergent procedures will be transferred to either Holston Valley Medical Center in Kingsport or Bristol Regional Medical Center following a consultation with their surgeon and medical team.

Those people currently hospitalized at JCMC will continue to be cared for in Johnson City, unless surgery is needed. In a memo to staff, the hospital system said it expects these changes to remain in place for five to 10 days.

“This action is being taken solely for the protection of patients and staff, and we anticipate the resumption of the service as soon as the team members are able to return,” the release said.

As of Monday, cardiovascular and thoracic surgeons remain on call at JCMC and will assist in helping triage patients as needed, and will continue to support the hospital’s trauma team with JCMC continuing to operate as a level one trauma center.

Ballad CEO sends letter to CMS urging exemptions, delay to federal COVID-19 vaccine mandate

Ballad Health CEO Alan Levine sent a letter on behalf of the hospital system Monday to the Centers for Medicare and Medicaid Services asking that the federal agency consider either allowing hospitals in areas with significant staffing shortages be exempt from the federal COVID-19 vaccine mandate for healthcare workers, or delay its implementation to give facilities more time to convince staff to voluntarily take the vaccine.

“CMS should consider permitting hospitals in health professional shortage areas to seek waivers from the mandate if they can demonstrate difficulties with retention of staff,” the letter said. “Those parts of the country which already suffer from shortages, and which are disadvantaged in terms of recruitment and retention, need to first do no harm in terms of staffing availability.

“Permitting health systems that can demonstrate staff retention challenges to seek waivers would be fair and would appropriately recognize the importance of balancing appropriate staffing levels at healthcare facilities with the administration’s desire to increase vaccination rates among healthcare workers.”

The letter continued to say that, in the absence of a waiver option, CMS should delay implementation of the mandate through at least June to “allow facilities located in the areas with the greatest healthcare workforce shortages time to implement policies and procedures aimed at improving vaccination rates.”

“This will also help ensure that individuals who are living in rural communities are not disproportionately impacted by staffing shortages that may occur as a result of employees refusing the vaccine,” the letter said.

Ballad also requested that CMS take a flexible approach to checking compliance and allow providers not in compliance to show it is “due to the facility prioritizing appropriate levels of staffing to care for the needs of the community it serves. In addition, it asked that the administrative burden of verifying vaccination be removed from providers, that the appropriateness of religious and medical exemptions is not included in compliance surveys, that employees with at least one dose be allowed to work if they comply with policies to reduce transmission of the virus and that the agency specify that the term “fully vaccinated” does not include booster shots.

The CMS mandate says fully vaccinated does not mean those who have received boosters or additional doses and that it considers staff who have completed a primary vaccination series (both doses of an mRNA vaccine or one dose of the Johnson & Johnson vaccine) as fully vaccinated.

“Given the new timelines released by CMS for compliance with the mandate, it is clear that the shots would have to be initiated by the end of January — well after the predicted peak of the omicron variant,” the letter said. “Thus, we don’t see how the current (interim final rule) helps mitigate the challenges before us — challenges made far worse by the H3N2 influenza strain, which is approaching us as children return to school and the winter weather keeps more people indoors.

“For these reasons, Ballad Health respectfully requests that CMS consider the following suggestions to help address the workforce shortages facing rural health care systems while we work to educate people about the vaccine and increase staff vaccination rates.”

Levine wrote that the system is already dealing with severe staffing shortages and is having difficulty attracting new workers, with labor costs increasing by more than $100 million as the system relies more heavily on contract labor. Levine said the system is on track to incur more than $115 million in contract labor costs for the 2022 fiscal year, with about 400 of 600 nursing openings filled with contract labor prior to the holidays.

After being delayed by legal challenges from several states, the federal vaccine mandate for healthcare workers is set to go into effect in 25 states where the mandate is not preliminarily enjoined as a legal challenge from those states makes its way through the judicial system. Tennessee is not part of the lawsuit, and thus healthcare workers in the state will need to receive their first shot by Jan. 27 and complete their vaccination series by Feb. 28, unless they receive a medical or religious exemption.

In November, following the announcement of the mandate, Ballad told staff they must be vaccinated unless they receive an exemption, but dropped the requirement in early December after a federal court temporarily suspended enforcement of it. Following the re-instatement of the mandate on Dec. 15, Ballad took issue with the “unequal application“ of the mandate and called it “unprecedented” to enforce such a mandate in only half of states.

“Until these issues are resolved such that there is an equal application of the federal rules, Ballad Health has no plans to take any action which might later end up being reversed by yet another court ruling,” read a Dec. 15 statement from Ballad. “Real people with real jobs are affected by all this, so it is imperative that a judicial resolution be reached either way as soon as possible so a fair and equal application of the rules is followed.”

Levine wrote Monday that at the time the system was implementing its mandate it had 2,000 employees who had not been vaccinated and did not seek an exemption — about 15% of its workforce.

“If the IFR were to be finalized in its current form, our facilities would likely be forced to turn away patients or reduce the services at our hospitals due to staff shortages,” Levine wrote. “In smaller facilities, even the loss of one or two staff members in critical positions can have a catastrophic effect on a facility’s ability to operate. The provision of critical health care services would be jeopardized and lives could be lost.”

Levine has taken issue with the federal mandate in the past, warning that it could worsen nursing and staffing shortages and spoke before a congressional subcommittee expressing those concerns to lawmakers in October. But, barring further legal challenges to the mandate, the hospital system will have to comply with in the order and require employees be vaccinated as healthcare providers not in compliance could face fines or be barred from participating in Medicare and Medicaid programs — something Levine previously said “would be devastating for our region.”

“Despite our many efforts, however, the unfortunate reality is that only 46.7% of the population we serve has been fully vaccinated. For various reasons, our region has a high level of vaccine hesitancy. This includes a high level of vaccine hesitancy among nurses,” the letter said. “While we estimate that more than 95% of Ballad Health’s physicians are vaccinated, we estimate that only about 60% of our non-physician team members are fully vaccinated.

“If CMS finalizes the IFR without acknowledging the impact this could have on existing labor shortages, rural health systems will be forced to terminate thousands of employees who are not comfortable taking the vaccine and our communities will suffer greatly.”


Hundreds without power as heavy snow blankets the region

Heavy snowfall knocked out power for several hundred people across Washington County on Monday, with BrightRidge reporting more than 700 outages — the majority of which were reported in the southern end of the county.

While most outages were concentrated in areas like Lamar, Cherokee and Jonesborough, many were also reported in Austin Springs, Boones Creek and Johnson City. Washington County Sheriff Keith Sexton said in a press release that roads in the southern part of the county were hazardous, and urged people to stay home until conditions improved.

Much of Northeast Tennessee was under a winter storm warning since late Sunday night as snow storms moved into the area with the potential to dump as much as half a foot of snow in some areas. The warning expired at 10 a.m. Monday.

Although several inches of snow fell over Carter County and Elizabethton, there were few serious problems caused by the storm.

The Carter County Highway Department and Elizabethton Street and Sanitation Department worked to clear the streets and roads. The Highway Department said the streets even at the highest elevations were in good condition during the afternoon.

The Elizabethton Electric Department reported that there were only a few scattered outages on Monday and that the biggest outage happened before the storm. A tree fell across the power lines in Long Hollow while the storm was still producing rain, sometime after 4 a.m. The tree caused several residences to lose electrical service for a while but Marketing and Industrial Services Coordinator Ken Markland said the service was quickly restored.

Johnson County also reported only a few power outages.

Carter County Emergency Management Director Billy Harrell said his department has received no calls during the storm.

The region may not be done with treats of winter weather this week. The National Weather Service reports that another winter weather system will affect the region Thursday night and Friday with the possibility of more snowfall accumulations.

Elizabethton Bureau Chief John Thompson contributed to this report.


Left, Son and Mailu Wilson show off Emily the snowgirl.

Autumn Hancock photographed the snow falling in the Sherwood Forest neighborhood of Johnson City.


Michael Lambros of Johnson City submitted this photos of a child enjoying “his first real snow.”

Cormac Bohannon of Johnson City enjoys the snow in a photo submitted by Joy Bohannon.

Katie Mays captured this snow scene in Unicoi.

Children got a chance to enjoy the winter’s first snowfall. Anna Hackler submitted this photo taken in Elizabethton.

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Sheriff Keith Sexton: 'Suspicious circumstances' in Jonesborough woman's death under investigation

A Jonesborough woman was found dead inside a barn on her property over the weekend, and the death is being investigated as suspicious, according to a press release from the Washington County Sheriff’s Office.

Eula Miles, 73, was found around 1 p.m. Saturday, Sheriff Keith Sexton said in the press release.

Deputies and emergency medical personnel responded to a residence on Conklin Road about an unattended death. When investigators found Miles inside the empty barn, “suspicious circumstances present,” led the sheriff’s office to begin a formal investigation.

Sexton said the Tennessee Bureau of Investigation was called in to assist the sheriff’s office in determining how Miles died.

“After the preliminary investigation was completed, the body was transferred to the William L. Jenkins Forensics Center at ETSU for a pending autopsy. Those findings necessitate an investigation,” Sexton announced in the press release.

While the TBI was called in to assist in the probe, the sheriff’s office will lead the investigation, he said. Those findings will be turned over to the District Attorney General’s Office for further review.

Anyone with information regarding this death is asked to call 423-788-1414.

Owner of noted former barbecue restaurant dead at 72

Alan Howell, a well-known local restauranteur who had a fondness for “The Andy Griffith Show,” politics and sailing, died on Dec. 30 at the age of 72.

A longtime resident of Piney Flats, Howell was the owner of Dixie Barbeque in Johnson City, which was a favorite hangout for fans of barbecue and local political gossip.

He closed his beloved eatery on Dec. 31, 2015, after more than 28 years of operation at its 3301 N. Roan St. location.

“Johnson City’s been good to me,” Howell told this paper on Dixie’s final day of business. “The Tri-Cities have been good to me. Lots of publications have written about us, from Southern Living to local newspapers like the Johnson City Press. And we’ve had customers from all over the world — from Australia and Greenland to Japan, Germany and Tasmania, some of whom have come back over the years.”

Howell was a native of Carter County where his father, William “Dottie” Howell, worked as a labor organizer in the region. He was a graduate of Happy Valley High School and earned a degree in human resources from Steed College in 1973.

Howell worked in the local restaurant and food industry for many years. He operated Richard A’s on Walnut Street in Johnson City for several years before opening Dixie Barbeque in the late 1980s.

Dixie offered a menu that featured chicken and pork barbecue, potatoes and onions and barbecue beans. Howell also featured a traditional Brunswick stew and an Alabama white sauce from recipes given to him by friends.

Howell insisted that beach music was always played in his restaurant, along with reruns of “The Andy Griffith Show” shown on two TVs inside the eatery.

He was also a fan of sailing and would often go on sailing trips in the Caribbean with friends and colleagues from the restaurant business.

“The beauty and the art of the sail is just breathtaking,” Howell told the Press in 1998. “The idea of using wind to move you to where you want to go is idyllic, and on some days, almost spiritual.”

Howell was also a staunch Democrat, who enjoyed talking politics with friends and customers from both sides of the political aisle. A leader of the Sullivan County Democratic Party, Howell ran for his party’s nomination for Tennessee’s 1st District seat in Congress in 2006.

A memorial service for Howell will be held Thursday at 2 p.m. in the chapel of Tetrick Funeral Services. His family will receive friends in the Sunset Room of Tetrick Funeral Services, following the memorial from 3 to 6 p.m.