Key Compliance Factors for Healthcare Employers during COVID-19

The transmission of any virus is always a concern for health care practices as they navigate how to treat their patients appropriately while keeping both patients and staff safe.  With COVID-19 infections, that concern is even greater.  As a result, CDC guidelines and OSHA compliance are a must for any health care provider and practice.

As COVID-19 protocols and procedures continue to evolve on a nearly daily basis, all health care providers should ensure that their practices remain compliant with all OSHA and CDC recommendations during this time.  There are ever changing recommendations with respect to PPE (personal protective equipment), pre-screening of patients and staff, and waiting room protocols just to name a few. While OSHA and CDC guidelines are similar, they may differ slightly. CDC guidelines are based on PPE supply chain considerations, while OSHA’s guidelines are written to help employers remain in compliance with federal standards for respiratory protection.

OSHA recommends that all employers assess the hazards to which their employees may be exposed in all healthcare facilities. These assessments are grouped by exposure level risk, ranging from “lower” risk to “very high” risk. For example, “lower” risk employees may perform administrative duties in a non-public area of the hospital, while “very high” risk employees may perform procedures such as intubation (or other aerosol-generating procedures) or may collect specimens from COVID-19 patients.

OSHA also recommends that healthcare facility employers implement a series of both engineering and administrative controls to decrease the risk of infection across the workplace. In terms of engineering controls, OSHA encourages the use of airborne infection isolation rooms (AIIRs) with proper ventilation. However, where an AIIR is not available, OSHA recommends isolating patients in a private room – preferably, this room should be a negative-pressure room, but isolation tents or other containment structures can suffice in their absence.

In terms of administrative guidelines, OSHA recommends that healthcare facilities not only isolate COVID cases, but that they isolate suspected cases away from confirmed cases to further reduce the risk of transmission. The number of healthcare and support personnel entering the rooms of either confirmed or suspected patients should be limited, and all workers should be trained on the appropriate use of PPE. This includes personnel performing tasks like housekeeping and hospital meal services. OSHA encourages facilities to follow CDC signage guidelinesfor marking rooms of suspected or confirmed cases.

To follow safe work practices, all personnel should perform work tasks in areas away from suspected or confirmed COVID patients. This includes activities traditionally completed inside patient rooms, such as charting. Personnel should limit transmission opportunities by decreasing touch contamination and avoiding unnecessary handling of environmental surfaces. Where such touching is necessary, personnel should work from “clean to dirty,” touching clean surfaces before dirty ones.

Both OSHA and the CDC recommend the use of personal protective equipment (PPE). OSHA recommends the use of gloves, gowns, eye/face protections, and NIOSH-certified N95 facepieces. The CDC offers guidelines for maximizing the use of PPE in shortage situations and recommends that healthcare facilities experiencing PPE shortages carefully plan and implement crisis capacity strategies. This includes prioritizing the use of PPE and using intact PPE beyond manufacturer-designed shelf life capacity. They also offer specific guidelines for each type of PPE here.

You can read more of OSHA’s healthcare facility guidelines here.

It is important to remember that these guidelines exist in an ever-changing landscape. Guidelines that exist today may have evolved by tomorrow. Therefore, it is crucial that you continue to study available resources and materials that can help you remain in compliance with both CDC and OSHA guidelines.

Baxter Baker’s attorneys are here to help you and your health care practice navigate this new regulatory compliance world in the face of COVID-19.  If you have any questions, do not hesitate to contact Danielle M. Vranian at 410-230-3812 or Gary R. Jones at 410-385-8004.