On Saturday, the NYS Department of Health (DOH) released new protocols for health care personnel (HCP) returning to work following exposure to COVID-19 and those that have recovered from infection. The protocols apply to all health care settings, including hospitals, nursing homes, adult care facilities, end-stage renal disease facilities, emergency medical services, home care, outpatient clinics, and private practices.
These guidelines will apply when the option of furloughing employees would result in staff shortages that would adversely impact the operation of the health care entity.
Key Points
Providers and Staff Exposed to Confirmed or Suspected COVID-19 Cases
Entities may allow HCP who have been exposed to a confirmed case of COVID-19 or who have traveled internationally in the past 14 days to work if all the following conditions and safeguards are met:
- HCP should self-monitor twice a day (temperature and symptoms), should undergo temperature monitoring and symptom checks at the beginning of each shift and at least every 12 hours during a shift.
- HCP should wear a facemask while working until 14 days after the last high-risk exposure.
- To the extent possible, HCP should be preferentially assigned to patients at lower risk for severe complications (e.g., on units established for patients with confirmed COVID-19) as opposed to higher-risk patients (e.g., severely immunocompromised, elderly individuals).
- HCP allowed to work under these conditions should maintain self-quarantine while not at work.
- If the HCP becomes symptomatic, they should immediately stop working and isolate at home. All staff with symptoms consistent with COVID-19 should be managed as if they have this infection regardless of the availability of test results.
Providers and Staff With Confirmed or Suspected COVID-19
In order to return to work, HCPs with confirmed or suspected COVID-19 must have:
- Maintained isolation for at least seven days after the illness onset
- Been fever-free for at least 72 hours without fever-reducing medication
- Must show improvement in other symptoms
If the HCP are asymptomatic but tested and found to be positive, they must maintain isolation for at least seven days after the date of the positive test. If the individual develops symptoms during this time, to return to work, they:
- Must maintain isolation for at least seven days after the illness onset
- Must have been fever-free for at least 72 hours without fever-reducing medications
- Must be showing improvement in any other symptoms
Staff who are recovering from COVID-19 should wear a facemask while working until 14 days after the onset of illness if mild symptoms persist but are improving.
To the extent possible, HCP should be preferentially assigned to patients at lower risk for severe complications (e.g., on units established for patients with confirmed COVID-19) as opposed to higher-risk patients (e.g., severely immunocompromised, elderly individuals).
HCP allowed to work under these conditions should maintain self-quarantine while not at work.
Best Practices for Providers
The DOH further emphasized that COVID-19 testing should be prioritized for hospitalized health care workers. The DOH also recognizes that flexibility is essential, and, as this pandemic worsens, all HCP may need to be assigned to treat all patients regardless of risk level.
Employees who are furloughed due to isolation or because they do not meet the above conditions for returning to work qualify for paid sick leave benefits, and employers can provide them with a letter for purposes of demonstrating eligibility for benefits.
These new protocols give welcome guidance to facilities as well as private medical and dental practices in allowing employees back to work after exposure to or infection with COVID-19. Not only do these protocols assist in containing the spread of disease by defining strict safety measures, but they provide useful, objective standards for making decisions on returning to work.
Entities must be diligent in documenting adherence to the letter of the protocols. Providers and employees must be questioned about possible exposure to COVID-19 both within and outside the health care setting. Symptoms—or a lack thereof—must be documented at the beginning of each shift. Temperature checks must be enforced and documented. Employees must certify they have followed the guidelines for isolation and quarantine. If a health care entity or practice rigidly follows the guidelines, it is unlikely that any liability will result in the event there is a COVID-19 transmission.
If you have any questions regarding the content of this alert, please contact Fran Ciardullo, special counsel, at fciardullo@barclaydamon.com or another member of the firm’s Health Care & Human Services Practice Area.
We have a specific team of Barclay Damon attorneys who are actively working on assessing regulatory, legislative, and other governmental updates related to COVID-19 and who are prepared to assist clients. You can reach our COVID-19 Response Team at COVID-19ResponseTeam@barclaydamon.com.