Category: News

Guidance directly from the Centers For Disease Control (CDC) as of 3/12/20

Actively encourage sick employees to stay home:

• Employees who have symptoms of acute respiratory illness are recommended to stay home and not come to work until they are free of fever (100.4° F [37.8° C] or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants). Employees should notify their supervisor and stay home if they are sick.
• Ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are aware of these policies.
• Talk with companies that provide your business with contract or temporary employees about the importance of sick employees staying home and encourage them to develop non-punitive leave policies.
• Do not require a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, as healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way.
• Employers should maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.

Separate sick employees:

CDC recommends that employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath) upon arrival to work or become sick during the day should be separated from other employees and be sent home immediately. Sick employees should cover their noses and mouths with a tissue when coughing or sneezing (or an elbow or shoulder if no tissue is available).

Emphasize staying home when sick, respiratory etiquette and hand hygiene by all employees:

• Place posters that encourage staying home when sick, cough and sneeze etiquette, and hand hygiene at the entrance to your workplace and in other workplace areas where they are likely to be seen.

• Provide tissues and no-touch disposal receptacles for use by employees.
• Instruct employees to clean their hands often with an alcohol-based hand sanitizer that contains at least 60-95% alcohol or wash their hands with soap and water for at least 20 seconds. Soap and water is preferable if hands are visibly dirty.
• Provide soap and water and alcohol-based hand rubs in the workplace. Ensure that adequate supplies are maintained. Place hand rubs in multiple locations or in conference rooms to encourage hand hygiene.
• Visit the coughing and sneezing etiquette and clean hands webpage for more information.

Perform routine environmental cleaning:

• Routinely clean all frequently touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
• No additional disinfection beyond routine cleaning is recommended at this time.
• Provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.

Advise employees before traveling to take certain steps:

• Check the CDC’s Traveler’s Health Notices for the latest guidance and recommendations for each country to which you will travel. Specific travel information for travelers going to and returning from China, and information for aircrew, can be found on the CDC website.
• Advise employees to check themselves for symptoms of acute respiratory illness before starting travel and notify their supervisor and stay home if they are sick.
• Ensure employees who become sick while traveling or on temporary assignment understand that they should notify their supervisor and should promptly call a healthcare provider for advice if needed.
• If outside the United States, sick employees should follow your company’s policy for obtaining medical care or contact a healthcare provider or overseas medical assistance company to assist them with finding an appropriate healthcare provider in that country. A U.S. consular officer can help locate healthcare services. However, U.S. embassies, consulates, and military facilities do not have the legal authority, capability, and resources to evacuate or give medicines, vaccines, or medical care to private U.S. citizens overseas.

Additional measures which can be taken in response to sporadic importations of the COVID-19:

• Employees who are well but who have a sick family member at home with COVID-19 should notify their supervisor and refer to CDC guidance for how to conduct a risk assessment of their potential exposure.
• If an employee is confirmed to have COVID-19, employers should inform fellow employees of their possible exposure to COVID-19 in the workplace but maintain confidentiality as required by the Americans with Disabilities Act (ADA). Employees exposed to a co-worker with confirmed COVID-19 should refer to CDC guidance for how to conduct a risk assessment of their potential exposure.

For the majority of us, the terms furlough, layoff, and reduction in force (RIF) all sounded like words we would never really need to concern ourselves with. Unfortunately, with the novel Coronavirus infiltrating all our communities, these terms have rapidly become a thought in many of our minds. So what exactly does furlough, layoff, and RIF mean for in regards to your hospital’s team?

All three of these terms describe actions that are intended to achieve cost savings by reducing a company’s payroll costs. Even though the words have been used interchangeably, their true meanings are quite different.

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Furlough

A furlough is considered an alternative to a layoff. When an employer furloughs its employees, it requires them to work fewer hours or to take a certain amount of unpaid time off. For example, an employer may furlough its nonexempt employees one day a week for the remainder of the year and pay them for only 32 hours instead of their normal 40 hours each week.

Another method of furlough is to require all employees to take a week or two of unpaid leave sometime during the year. Employers must be careful when furloughing exempt employees so that they continue to pay them on a salary basis and do not jeopardize their exempt status under the Fair Labor Standards Act (FLSA). A furlough that encompasses a full workweek is one way to accomplish this since the FLSA states that exempt employees do not have to be paid for any week in which they perform no work.  

An employer may require all employees to go on furlough, or it may exclude some employees who provide essential services. Generally, the theory is to have the majority of employees share some hardship as opposed to a few employees losing their jobs completely.

Employees that have been furloughed should qualify for unemployment. Check with your local unemployment websites to see if the employees would qualify for an Unemployment Insurance Workshare Program for a partial reduction in hours or for a temporary loss in all work employees should be able to receive unemployment. During the COVID-19 crisis, most states have waived the waiting period for receiving unemployment.

It is also important to note that during a furlough the employer must maintain the employee’s benefits. The employer would need to determine if they are going to pay 100% of the benefit premiums, create a repayment plan for the employee’s portion of the insurance premium when the employee returns to work, or if the employee will be responsible for paying their portion of the insurance premium to the employer or directly to the insurance carrier while on furlough.

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Layoff

A layoff is a temporary separation from payroll. An employee is laid off because there is not enough work for him or her to perform. The employer, however, believes that this condition will change and intends to recall the person when work again becomes available. Employees are typically able to collect unemployment benefits while on an unpaid layoff, and frequently an employer will allow employees to maintain benefits coverage for a defined period of time as an incentive to remain available for recall.

When an employer lays off an employee, they must follow all state and federal guidelines regarding termination and final pay guidelines. This means employers may have to pay out accrued PTO, Vacation, and/or Sick Time.

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Reduction in Force (RIF)

A RIF occurs when a position is eliminated without the intention of replacing it and involves a permanent cut in headcount.  A layoff may turn into a RIF or the employer may choose to immediately reduce their workforce. A RIF can be accomplished by terminating employees or by means of attrition.

When an employee is terminated pursuant to a reduction in force, it is sometimes referred to as being “riffed.” However, some employers use layoff as a synonym for what is actually a permanent separation. This may be confusing to the affected employee because it implies that recall is a possibility which may prevent the employee from actively seeking a new job.

When an employer “riffs” an employee, they must follow all state and federal guidelines in regards to termination and final pay guidelines. This means employers may have to pay out accrued PTO, Vacation, and/or Sick Time.

We know that these three options weigh heavily in your minds as practice owners. You should be prepared for the worst-case scenario of having to use one of these steps, but we strongly recommend that you try to exhaust all other alternatives to any form of layoff prior to getting to this step.

The COVID-19 Crisis has stirred up a lot of questions regarding appointment scheduling and what services practices should push out into the future.

By this point, you have probably come up with a strategy for how to handle wellness appointments, how to handle elective procedures, and whether you are going to accept drop-off patients or not. Then you probably got to the Boarding column in your Practice Management Software and wondered: what should I do with these boarding appointments?

As of March 17, 2020, most states and localities are considering veterinary practices an essential business, so they can stay open while other non-essential businesses are being asked to close to help mitigate the spread of the virus. Despite this, a lot of practices are starting to question if they will have to temporarily close their doors due to an employee testing positive for COVID-19. This is a reasonable concern that brings us back to our original question: what are you going to do with your boarding patients if you must suddenly close for health and safety purposes?

We recommend that practices still offer boarding services to their clients, but with the contingency that emergency contacts for all boarders are required prior to dropping off. Your reception team should be reaching out to your scheduled boarding appointments and informing them that you are still open and are still looking forward to hosting their pet soon, but due to current circumstances with COVID-19 the following requirements have been put in place:

• Any pet that will be boarding with the practice will need to have a local emergency contact on file. This emergency contact will only be used if the practice would need to suddenly close due to health and safety reasons or has been compelled to do so by local governing agencies.

• The emergency contact must be able to come pick up the pet that same day they are contacted by the practice. It will be the pet owner’s responsibility to ensure that the emergency contact is aware that they may need to pick up the pet on short notice.

• Payment for the shorter stay will be adjusted and will be communicated to the pet owner via their preferred form of contact (i.e. phone, text, email).

Upon arrival for their scheduled drop-off time, clients should complete an emergency contact form in addition to the routine boarding paperwork. Clients should not be allowed to drop off their pet for boarding if they cannot provide an emergency contact for their pet.

With this small addition to your boarding policy, we hope you can feel confident in continuing to provide boarding services to your clients, despite the current uncertainty with COVID-19 in your community.

Many practices are starting to come to the realization that one day one of their employees may inform them that they have tested positive for COVID-19. So, as an employer, what should you do when this happens?

Recent literature and media reports have suggested that the virus has a 14-day incubation period, which is why you most likely have heard of a 14-day self-quarantine recommendation. But in theory, this could mean that the actual window would be 28 days since some reports state that individuals can be contagious without showing symptoms.

Based off of this logic, if you have an employee come to you on March 15^th to inform you that they tested positive for the virus then anyone they came into contact with from March 1^st on may be at risk for exposure to the virus.

With this in mind, here are some steps to consider taking when you are informed by an employee that they have tested positive for COVID-19:

1. If an employee becomes infected with COVID-19 or is exposed to COVID-19…
   1. can the employee work from home during their self-quarantine? Some management team members can perform their tasks remotely and some employees can assist with telemedicine appointments remotely.
   2. if the employee cannot work from home, then will the employee be paid for the 14-day self-quarantine?
   3. if the practice is not going to compensate the employee while on a 14-day quarantine will the employee be allowed to utilize their accrued sick time, vacation time, and/ or Paid Time Off (PTO)?

Keep in mind that in some states, employees who are being self-quarantined may qualify for state disability and/or FMLA (if you have 50 or more employees) and/ or state mandate Family Leave Acts.

Your Infected Employee

• Instruct your infected employee to stay home for at least a 14-day self-quarantine. Keep in mind that depending on the employee’s symptoms their health care provider may recommend for the employee to be quarantined for longer than 14-days.
• Assure the employee that their name will not be disclosed when informing the team of their possible exposure to the virus. This will ensure that you are in compliance with the Americans with Disabilities Act (ADA).
• In order to determine the window of who may have been exposed to the virus within the practice, ask the infected employee when they tested positive for COVID-19. This date will help you determine the 14-day window prior to their positive test and will also help you identify the employee’s potential return date from self-quarantine.

For example:  If the employee tested positive on March 15, 2020, any employee that may have come into contact with the infected employee or the area they worked in from March 1^st through the 14^th (first 14-day window) could be at risk for contracting the virus. The second 14-day window would be from March 15^th through March 29^th for the infected employee’s self-quarantine. Based off the employee’s health care provider’s recommendation this second waiting period could be extended.

• Ask the infected employee to identify all areas of the office that they were present in during the first 14-day window (from the above example March 1^st– March 14^th). These areas will need to be professionally sanitized or cleaned in accordance with CDC guidelines.

• Ask the infected employee to identify which co-workers they came into contact with during the first 14-day window.

Your Team

• Contact the employees with whom your infected employee had contact and inform them that a co-worker in the practice who they may have had contact with has tested positive for COVID-19. Be sure to not specifically name the infected employee to remain in compliance with the ADA.  

• Inform the employees who have been in contact with the infected employee that as a precaution they are being asked to self-quarantine for 14-days. Set clear expectations with the employee on when their expected return date will be and whether the employee will be compensated while on leave.

• Encourage the affected employees to reach out to their health care provider regarding next steps, if any, or if the 14-day quarantine is sufficient.

• Inform the rest of the team that during the previous two weeks someone who works in the practice has tested positive for COVID-19. Advise them that the practice will be closing to be sanitized and inform them of the anticipated date for it to reopen. Encourage anyone with concerns to speak with the Practice Owner or Practice Manager.

Depending on the size of the practice and the number of people exposed to the infected employee, practice owners may need to consider closing the hospital completely for the 14-days. All employees would be asked to stay home for safety precautions and would be asked to self-quarantine to help mitigate further spread of the virus.

Above all else, keep calm. The hospital team is looking towards their leadership team for guidance. They need to be reassured that these hard choices are being made to ensure their health and safety are the practice’s top priority.