- Healthcare facilities must be in full compliance with the Occupational Safety and Health Administration's Emergency Temporary Standard as of Wednesday, including requirements around ventilation, physical barriers and training.
- The American Hospital Association, Association of American Medical Colleges and other groups had pushed the agency to delay compliance dates, contending providers needed more time to make sense of the policy and implement its new requirements. OSHA declined to do so.
- Instead, OSHA extended the comment period from Wednesday to Aug. 20, though the ETS is already in effect. It also released its field inspection and enforcement procedures for enforcing ETS compliance at healthcare facilities.
Healthcare workers and the labor unions representing them have pushed hard for stricter safety standards amid shifting guidance from federal agencies during the worst of the pandemic. Almost a year later, OSHA finalized an ETS targeting healthcare facilities like hospitals, nursing homes and other sites of care to protect workers from COVID-19.
Most of the ETS makes previous pandemic guidance like masking and social distancing mandatory, though provider groups say the lengthy rule is confusing and tricky for some to implement in just 30 days, especially with a variety of exemptions for vaccinated employees.
"This rule is long and complex, and would require changes in hospital policies, procedures and structures," AHA wrote in a letter asking the agency to delay compliance dates by six months.
"Our members have told us that they need more time to implement the many new requirements contained in the 916-page ETS," the letter said.
Employers were required to comply with most provisions by July 6, and all provisions by Wednesday.
The standard covers a variety of guidelines federal agencies put out throughout the pandemic to stem the spread of COVID-19, including that providers have a written plan for how they would deal with an outbreak. The ETS outlines detailed requirements around patient screening, personal protective equipment, ventilation and physical barriers.
It also requires healthcare employers to provide workers with paid time off to get vaccinated or recover from any side effects, and employees sick or exposed to the virus must be given proper accommodations.
While the standard doesn’t mandate any employees get vaccinated against the virus, it allows a number of exemptions for those with the vaccine, so long as employers have adequate documentation, according to an OSHA webinar on the ETS. OSHA said it will update the standard if necessary to align with CDC guidance.
Provider groups say their members have largely been following most of the guidelines over the past year or made their best attempts to do so.
"Implementing a new layer of requirements at this late stage of the public health emergency (PHE) is duplicative, confusing, and will divert time and resources away from patient care," the Medical Group Management Association wrote in a letter.
"Moreover, the ETS will hold physician practices to a standard on which they were denied the opportunity to provide feedback, before being required to comply," the letter said.
As the standard covers all healthcare facilities, certain providers may find requirements disrupting their workflows or operations, Claire Ernst, associate director for government affairs at the Medical Group Management Association, said.
Detailed requirements around patient screening, for example, could be tricky in a pediatrician's office.
"Basically this list of symptoms is what every kid presents," Ernst said.
Upon release of the ETS, the agency said it acknowledged some employers may be unable to comply with certain requirements by specified dates and it would use its discretion in issuing citations. A Department of Labor spokesperson did not answer whether non-compliant facilities would face a monetary penalty.