TO: Ballad Health All
FROM: Ballad Health Corporate Emergency Operations Center
DATE: Jan. 14, 2022
TITLE: COVID-19 briefing
ACTION: Please post and cascade to all team members. This is a review of the major activities that have recently occurred related to the COVID-19 response.
COVID-19 inpatient cases: 322
COVID-19 patients in ICU: 75
COVID-19 patients on ventilators: 57
Pediatric inpatients with COVID-19: 4
Patients in Safer at Home, COVID-19 care at home, program: 246
Percent of fully vaccinated population in Ballad Health’s 21-county service area: 47.7%
The U.S. Supreme Court ruled Thursday that the CMS mandate for healthcare workers to be vaccinated for COVID-19 can go forward. This was in effect previously for Ballad Health, then was suspended, and now has been reimposed. See details below.
Our patient volumes and positivity rates are at heightened levels as the Omicron variant of COVID-19 continues circulating through the Ballad Health service area. To combat the spread of this virus, which is more contagious than previous COVID-19 variants, we are taking several steps, including upgrading our face-masking requirements and our Family Birth Center visitation guidelines.
PLEASE NOTE: Beginning the week of Jan. 17, surgical masks will be required for all patients, visitors and team members in Ballad Health facilities.
This briefing includes information on:
- Update on Supreme Court ruling on CMS vaccination mandate
- Upgraded masking policy
- Reminder on team member meetings, meal gatherings
- Family Birth Center visitation guideline update
- Access to EVUSHELD treatment
Supreme Court ruling on CMS vaccination mandate
The U.S. Supreme Court has ruled that the Centers for Medicare and Medicaid Services (CMS) mandate for all healthcare workers to receive the COVID-19 vaccination is constitutional and can go forward. This means Ballad Health team members will be required to receive the vaccination unless they have an approved religious or medical exemption. More details about exemptions, vaccination schedules and deadlines will be communicated across the system as soon as they are finalized.
- This is the mandate that was in effect in December 2021 but was halted when several states appealed the mandate to the Supreme Court. It affects about 10 million healthcare workers nationwide.
- Any healthcare organizations that receive Medicare or Medicaid funding must comply or risk substantial and potentially devastating financial penalties.
- On Jan. 3, Ballad Health submitted a letter to the administrator of CMS, outlining our concerns with a sweeping federally imposed COVID-19 vaccine mandate for healthcare workers. In it, we also provided recommendations to CMS in the event the Supreme Court were to permit the mandate moving forward. We hope CMS will take our recommendations into serious consideration.
-
- Among other things, these recommendations included permitting hospitals in health professional shortage areas to seek waivers from the mandate if they can demonstrate difficulties with retention of staff. In the absence of offering the option to seek a waiver, we requested CMS consider delaying implementation of the vaccine mandate at least through June for hospitals, like ours, that meet the criteria.
- In the meantime, Ballad Health must comply with the Medicare Conditions of Participation or risk leaving hundreds of thousands of people insured through the Medicare and Medicaid program in our region without access to their trusted healthcare providers.
NOTE: While the Supreme Court permitted the CMS vaccination mandate to go forward affecting healthcare organizations, on Thursday it blocked the OSHA (Occupational Safety & Health Administration) mandate for large companies. For Ballad Health as a healthcare organization, the CMS mandate ruling supersedes the OSHA mandate ruling.
Updated masking requirements for patients, visitors and team members
Beginning the week of Monday, Jan. 17, all patients, visitors and team members will be required to wear surgical masks while in any of our Ballad Health facilities.
Several recent studies have demonstrated that cloth masks do not provide optimal protection. The Centers for Disease Control & Prevention (CDC) also recommends better-quality masks over cloth coverings to protect against an airborne virus. The Omicron variant is highly contagious.
- When patients and visitors arrive at our hospitals and clinics, they will be provided with a surgical mask at no cost, at screening or check-in locations. Visitors and patients who are already wearing a medical-grade mask (surgical/procedural, N-95, KN-95 or KF94) will not be asked to replace their masks.
- Team members working in all hospitals, clinics and offices will also be required to wear medical-grade masks which, at a minimum, are surgical masks and include higher-grade respirator masks (N95, KN95 or KF94).
- Team members may wear a cloth mask when entering the facility but must replace it with a surgical mask upon reporting to work. Surgical masks will be provided to team members at no cost for use on the job.
- Cloth masks will no longer meet the face covering requirement.
- Clinical team members will continue wearing the appropriate masking, eye protection and PPE outlined in our policies.
- Department leaders should follow their standard procedure for ordering supplies from Ballad Health Central Supply to request masks for their team.
Given the recent surge in COVID-19 cases within our workforce and community, we also recommend team members consider wearing their own medical-grade masks, when appropriate, outside of work.
Updated Family Birth Center visitation guidelines
To help contain the virus and protect patients and team members, we are updating the visitation guidelines for Family Birth Centers in our hospitals.
- Ballad Health labor and delivery visitation guidelines will continue allowing one designated patient-support person and two designated visitors per room, at a time.
- A doula is considered part of the care team and not considered a visitor.
- Patients will designate their support person and visitors upon admission, and they will remain the same for the entire length of stay. We will no longer allow visitors to switch out.
Meetings and meals
As a reminder, avoid congregating for meals, meetings and events.
- Team members should avoid dining in groups during meal breaks and avoid group meetings and celebrations that include meals. Because gathering for meals means taking off the facemask to eat, we are finding – through contact tracing – that it’s a notable cause of spread within our team. Remember, Omicron is much more contagious than other COVID-19 variants.
- Social distancing of 6 feet is required, including in break areas.
- We have reinstated guidelines for all internal meetings to be in virtual format or to take place by phone. In-person meetings should only take place when necessary and all participants must remain masked, regardless of vaccination status.
EVUSHELD to be distributed to clinicians
Ballad Health is now offering access to a new treatment called EVUSHELD that could protect some of our most vulnerable patients. It is the first-ever monoclonal antibody cocktail authorized by the FDA for the prevention of COVID-19 prior to exposure. Details about EVUSHELD are being communicated to our medical staff and order sets are accessible through Epic and the Ballad Health Community Physician Portal.
- Made by AstraZeneca, the medication is used as a long-term preventative for people who have not yet been exposed or infected with COVID-19. EVUSHELD could benefit those with weakened immune systems or with severe allergies and a history of adverse reactions to a COVID-19 vaccine.
- The FDA authorized emergency use of EVUSHELD on Dec. 8 for certain adults and children 12 and older weighing at least 88 pounds. Those who might benefit from this treatment include cancer patients, organ transplant recipients and patients taking immune-suppressing drugs.
Questions?
Have a question about EVUSHELD, vaccines, the Omicron variant or a new policy? Contact the Ballad Health Corporate Emergency Operations Center at BalladHealthCorporateEOC@balladhealth.org.
