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Ballad Health announced it would reinstate its vaccine mandate following a ruling from the U.S. Supreme Court allowing the Centers for Medicare and Medicaid Services to mandate that health care workers at facilities that receive federal funding be vaccinated.

“Ballad Health will take the appropriate steps to allow its team members to request religious or medical exemptions in compliance with federal law, and will comply with the Medicare Conditions of Participation, including the requirement that team members, and anyone interacting with our hospitals, be vaccinated,” a statement from Ballad read.

Ballad announced a vaccine mandate for staff in November, but dropped it after a federal judge temporarily suspended its enforcement in early December. A couple of weeks later the U.S. 5th Circuit Court of Appeals ruled that the mandate could stand in the 26 states — Tennessee among them — where it was not preliminarily enjoined.

In January, Ballad CEO Alan Levine wrote a letter on behalf of the hospital system asking the Centers for Medicare and Medicaid Services to consider allowing certain hospitals to be exempt from the mandate and took issue with the “unequal application” of it. In lieu of exemptions, the system asked the federal agency to delay enforcement of the rule until June to “allow facilities located in the areas with the greatest health care workforce shortages time to implement policies and procedures aimed at improving vaccination rates.”

“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 health care facilities with the administration’s desire to increase vaccination rates among healthcare workers.”

The U.S. Supreme Court on Thursday ruled that the mandate for health care workers at facilities that receive federal funds could go forward, with Chief Justice John Roberts and Justice Brett Kavanaugh joining the court’s liberal justices to form a 5-4 majority. Another mandate requiring employees at large employers to be vaccinated or submit to weekly testing was struck down, however.

The mandate for health care workers will affect more than 17 million people at approximately 76,000 health care facilities, according to the White House.

Levine, in his letter, warned that a mandate could worsen already critical staffing shortages, noting that when the regional hospital system first announced its mandate, 2,000 employees were unvaccinated and did not seek a medical or religious exemption.

That amounts to 15% of Ballad’s workforce, Levine said.

“If the (interim final rule) 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.”

Ballad’s statement on Thursday expressed hope that CMS will take the recommendations seriously.


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