1. Plan and prepare

Prepare for reopening by developing a step-by-step plan. Follow all federal, state, and local guidelines for reopening. Guidelines vary, so it’s important to stay up to date with all current legislation.

Follow industry-specific reopening and safety guidelines from reputable sources:

  • The Centers for Disease Control and Prevention (CDC) provides up-to-date national information on COVID-19 and recommended safety precautions. The center has provided Healthcare Facilities: Managing Operations During the COVID-19 Pandemic guidance tailored for health care centers.
  • The Centers for Medicare and Medicaid Services (CMS) has developed recommendations for reopening to provide non-COVID-19 medical care.
  • The Occupational Safety and Health Administration (OSHA) provides relevant information and safety suggestions for health care workers and employees.

Familiarize your office with programs such as the advance payment program from Medicare, which can help cash flow issues.

2. Make telemedicine the first option for care

Maximizing the use of telemedicine is strongly encouraged to protect health care professionals and patients from potential exposure to or transmission of COVID-19. Telehealth can be used to screen patients for COVID-19 symptoms and offer appropriate guidance, counsel non-COVID patients on the recommended course of action for their symptoms, and conduct guided physical therapy, mental health counseling, or follow-up appointments.

Have a clear office-wide plan for delivering telehealth and identify which staff members will be responsible for administering. Develop benchmarks to determine what patients should be advised to use telehealth and which patients will need in-person care, and utilize the indicators when scheduling appointments and planning for patient intake. The federal government has developed a resource page for providers to get started with telehealth and enforcing logistics such as billing, reimbursement, and other legal considerations.

3. Set safety measures in place

Prepare your facilities by taking the recommended safety precautions as outlined by the CDC. Arrange furniture to promote social distancing and limit patient interactions with staff. Create clear signage with safety requirements, prompts to encourage protective behaviors and social distancing, and capacity limits. Place hand sanitizer, tissues, and no-touch waste receptacles at key points of interaction, like check-in and waiting areas, or near exits.

The CDC has developed detailed infection prevention and control recommendations for health care personnel (IPC recommendations). Facility owners should familiarize themselves will all IPC recommendations and provide appropriate training to staff members.

Different roles within the office carry different risk, and the types of health care services offered will also impact risk for exposure from patients who may be asymptomatic carriers. Plan facility arrangements and safety measures with these risks in mind.

4. Plan for patient flow

Plan to schedule, intake, and conduct patient visits in a way that prevents the spread of COVID-19. When scheduling in-person appointments create a script that asks if patients have experienced any COVID-19 symptoms and have resources prepared to redirect the patient for treatment or testing as needed. Instruct patients ahead of time if they will need to reschedule their appointments if they are experiencing COVID-19 symptoms. Symptom-free patients should still be advised to wear a mask when coming in for an in-person appointment.

CMS has developed a tiered framework for assessing what actions or services to provide based on factors such as local COVID-19 infection rates, availability of staff, resources, and services, and urgency of the treatment. This framework can be used to evaluate if patients need to come in for an in-person appointment, if they are a good candidate for telemedicine, or if their appointment can be rescheduled.

Prepare for patient flow by limiting the number of in-person appointments are scheduled within a day and limit visitors to only those needed to assist or care for a patient. Have designated intake and waiting areas and consider screening patients upon arrival. 

5. Understand compliance requirements, legal implications, and liability

Contact your insurance carrier to understand how you are protected under your medical malpractice liability insurance. While Congress has offered some protections through the Cares Act that shield health providers from potential lawsuits during the COVID-19 pandemic, state protections vary. Stay up to date on employee leave law under the CARES Act. Additionally, connect with your local health department to understand how to compliantly report COVID-19 cases and report as required.

Reopening for health care facilities will be an ongoing process as states monitor risks for continued spikes or resurgences. Health care practitioners will need to stay responsive and be prepared to scale back or adjust their in-person services. Find more information to help your small business in our coronavirus resource center.

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