Risk of nurses leaving too high to mandate vaccine, says Ballad Health CEO

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Many healthcare workers are vaccinated against COVID-19, but others are refusing to do so as part of their employers' requirements. As a result, hospitals and health systems have lost employees, and one healthcare executive said a mandate could cost his 21-hospital system too many nurses.

"We have about 6,000 nurses in our system," Alan Levine, executive chair, president and CEO of Johnson City, Tenn.-based Ballad Health, told NPR. "If we are five or 10 nurses down in our system, we feel it. ... I have to keep as many nurses as I can who are capable of taking care of our community."

Mr. Levine's concerns about staff quitting because of vaccine requirements are substantiated; Lewis County Health System, a single-hospital system in Lowville, N.Y., said it will temporarily close its maternity unit after staff resigned over the state mandate. In South Carolina, Tidelands Health fired one of its employees for not complying with the Georgetown-based system's vaccine mandate. Among the most recent examples: After a two-week unpaid suspension period ending Sept. 14, 125 employees at IU Health left the Indianapolis-based organization after choosing not to receive the vaccine. 

President Joe Biden's administration also is taking steps to require COVID-19 vaccination for millions of American workers, including certain healthcare workers. The plan requires more than 17 million healthcare workers at Medicare- and Medicaid-participating hospitals and in other healthcare settings to be vaccinated against COVID-19. It also requires all employers with 100 or more employees to ensure that their staff are fully vaccinated or undergo weekly COVID-19 testing.

Hospitals have expressed concerns about what a mandate could mean for facilities already grappling with staffing strain.

While some larger systems may be able to handle a loss of employees, rural hospitals can be substantially affected by such an exodus, Alan Morgan, CEO of the National Rural Health Association, told USA Today.

He told the newspaper: "Right off the back, vaccines are safe and effective, and it's imperative that all rural healthcare workforce providers and staff need to be vaccinated. But we also know that there are higher rates of hospital workers that are unvaccinated and have no intention of getting vaccinated in the rural context. … This is a significant concern."

Mr. Levine told NPR that he's uncertain how the federal mandate will affect his hospitals, but he also is concerned about the effect on rural healthcare providers.

"I understand why the president felt the need to announce these mandates nationally, but each region of the country is different," he told the media organization. "In rural areas, it's very difficult."

On Sept. 17, Ballad Health, which serves counties in four statesreported 396 inpatients with COVID-19, 103 patients in the intensive care unit and 78 patients in the ICU using a ventilator. 

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