Ballad Health declares staffing crisis, will allow COVID-positive employees to work in limited capacity

“If an employee is at home, if they’ve tested positive with COVID but they are asymptomatic, our expectation is that they will come back,” Levine said, adding that “those who are symptomatic but whose symptoms have improved, we would invite them to come back under the same set of circumstances.”

Those who are symptomatic must be fever-free without the help of medication for at least 24 hours before they return. Levine said those who do return will not be allowed to work in certain departments such as oncology, the neonatal intensive care unit, birth and delivery, Niswonger Children’s Hospital and Hospitots Child Care Center.

“As a hospital system that has to care for patients that are very sick, there’s a point beyond which it becomes more risky to keep these people at home and not take care of the people that need help, and that’s the point we’re at.” Levine said. “We believe we’ve hit that threshold, both in terms of volumes of patients here at the hospital, as well as those at home with COVID that are employed by Ballad.”

Lisa Smithgall, Ballad’s chief nursing executive, said nurses are working more shifts and caring for more patients at once than they normally do, and she said “there simply aren’t enough bedside caregivers available to handle this crisis in our and other hospitals across the nation.” Smithgall also asked the public to avoid using emergency rooms unless there is a life- or limb-threatening emergency or if they’re experiencing shortness of breath, chest pain, stroke symptoms or other serious health emergencies.

“There isn’t enough staffing capacity to admit additional patients onto our inpatient floors, which is causing those overcrowding and longer wait times in our emergency departments,” Smithgall said.

In the past, Ballad had received additional staffing by way of the Tennessee National Guard, but Gov. Bill Lee’s executive order allowing National Guard members to work in hospitals was allowed to expire in November. Ballad officials have not had specific conversations with the governor’s office about re-issuing the executive order, but the system has requested additional support from Virginia Gov. Glenn Youngkin.

A fourth suspension of elective surgeries to free up additional staff is also unlikely.

“This time, we’ve made a decision that we’re not going to defer elective surgeries if we can avoid it,” Levine said.

The staffing crisis could worsen in the coming weeks, however, as employees face a Feb. 11 deadline from the hospital system to receive their first dose of the vaccine or receive an exemption — something hundreds of employees have yet to do. While roughly 60% of Ballad’s work force has been vaccinated, about 1,000 employees have not been vaccinated or sought a medical or religious exemption, Levine said.

If those employees remain unvaccinated and do not receive an exemption, the hospital system would be forced to terminate their employment in order to remain in compliance with the Centers for Medicaid and Medicare’s conditions for participation. Health care 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.”

Ballad’s deadline is two weeks later than the deadline set by CMS for health care workers in 25 states — Tennessee among them — as the hospital system waited to re-implement its mandate while a legal challenge made its way through the judicial system. Ballad announced it was re-instituting its mandate on Jan. 13 and has cleared its later deadline with CMS.

“We are going to do whatever we need to do to protect the safety of our patients, and to make sure we are adequately staffed to care for the needs of the people in this region,” Levine said. “We will do everything we can to work with CMS as we try to comply with the vaccine mandate. We’re not going to put our patients at risk. That is our position.”

On Thursday Ballad reported a record number of people hospitalized with COVID-19 at its hospitals with 436, breaking the previous record of 427 set on Wednesday. Of those hospitalized, 78 were in the intensive care unit and 55 were on ventilators. Eight children are also hospitalized with the virus. Ballad’s Chief Infection Prevention Officer Jamie Swift said the vast majority of those patients are hospitalized because of the disease, not because they tested positive after being admitted for other reasons.

Data from Ballad shows the vaccine has remained effective in preventing severe illness and hospitalization. Those who are not fully vaccinated account for 86% of hospitalizations, 92% of ICU patients and 96% of patients on a ventilator.

According to data from the Tennessee Department of Health, cases in the region had yet to start declining as of Jan. 22, but Ballad’s Chief Operating Officer Eric Deaton said they have seen fewer patients testing positive at their testing sites in recent days — giving them hope the surge may have peaked or will peak soon, though hospitalizations could remain above 400 for another week.

“As of right now we still feel relatively confident that our data is good, and we historically have had good information to base it on,” Deaton said.