RICHMOND, Va. (WRIC)- Attorney General Jason Miyares is threatening legal action over how one Virginia hospital system is handling its COVID-19 vaccine mandate. The outcome could have implications for those implementing similar policies under Republican leadership.

Miyares sent a letter informing Inova Health System that his office has been made aware of multiple employee religious and disability exemption requests that were denied. He alluded to a possible discrimination lawsuit and said the complaints are under review.

“These denials appear to be based on an incorrect judgment of the sincerely held religious beliefs of individuals, a breakdown in the interactive process, and an outright failure to accommodate reasonable request as required by law,” Miyares wrote. “These denials are resulting in terminations or threatened terminations of critical healthcare professionals in the Commonwealth.”

In an interview on Monday, Miyares said Inova may be in violation of the Virginia Human Rights Act.

“Any employer can’t discriminate against anybody based on their religious faith and put a test as to how sincere that religious faith may be,” Miyares said. “I took an oath of allegiance to the Virginia Constitution to enforce the laws of Virginia and that’s exactly what we’re doing.”

It’s still unclear if Miyares will pursue financial penalties against the hospital system. Miyares said his office has investigated similar complaints over COVID-19 vaccine mandates in the past but they’ve yet to take civil action in these cases under his leadership.

“It does not surprise me because it would be a difficult case,” said 8News Legal Analyst Russ Stone.

Stone said it’s difficult to know what the outcome of a potential case would be since COVID-19 vaccine mandates are still relatively new.

“Companies have an interest in keeping their employees healthy. Certain individuals may have legitimate religious objections to taking a vaccination. The balancing act is, just what does a person have to prove to assert that? That may be something that a court has to decide,” Stone said.

Miyares said he couldn’t share exactly how many complaints are being reviewed or reveal specifics about the cases.

Meanwhile, Kristen Barnett, a former RN unit supervisor in Inova Fairfax Hospital’s Pediatric ICU, is speaking out. She said she was initially granted a medical exemption to the COVID-19 vaccine mandate, which was later revoked without an explanation.

After filling out a lengthy form, including what she described as intimate questions, Barnett said her subsequent request for a religious exemption was shot down, even as others were approved.

“These are people who have given their lives through a really rough time in our nation and in the world over the last few years and we’re just kind of being discarded. It’s hurtful,” Barnett said. “The calling that God placed in my heart to serve my community as a nurse really was being counteracted with my faith. They both obviously are important to me, but I will always choose my faith over a job.”

Barnett said, while she refused to get the COVID-19 vaccine, she took other safety precautions like wearing a mask.

Isiah Kalinowski, an attorney with Bosson Legal Group, said he has been in touch with roughly two dozen people in the same situation.

In a statement, Inova said their “thorough and inclusive” review process for religious and medical exemption requests is consistent with the law. The health system said a spiritual care team makes decisions alongside a clinical and multi-disciplinary review panel.

“We strongly believe that the safest environment for our team members and patients is one where everyone is fully vaccinated. Like Inova’s longstanding requirement that all team members get an annual flu shot, compliance with our immunization policy is a condition of employment,” Inova’s statement continued.

It’s not uncommon for Virginia hospital systems to mandate COVID-19 vaccines for staff and at least some report losing employees because of it.

Last summer, the Virginia Hospital and Healthcare Association, a group representing 110 Virginia hospitals and 26 health delivery systems, formally endorsed the policy. Inova was among the first to fall in line.

Inova said, of their 20,000 team members, less than 1.2% have left their jobs because of non-compliance with their immunization policy. That could refer to as many as 240 employees.

Earlier this year, the U.S. Supreme Court struck down an attempted vaccine-or-test required for large private companies, but allowed a vaccine mandate for medical facilities that accept Medicare or Medicaid payments to stand.

The move pushed Ballad Health, a healthcare monopoly serving much of Southwest Virginia, to adopt a mandate, despite concerns over exacerbating staff shortages.

Bon Secours said, in compliance with the CMS mandate, all employees, contractors, vendors, students, volunteers and remote workers must be fully vaccinated or have an approved exemption. All new staff have 14 days from their date of hire to submit proof of vaccination or request an exemption.

In a statement, Sentara Healthcare said 99.6% of their 29,000 employees have complied with the COVID-19 vaccine requirement since October 2021. Sentara said it’s one of six shots required as a condition of employment for clinical staff.