How to Reopen Your Business After Coronavirus

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• When should I resume operations and bring the team back to work?
• What if there’s another stay-at-home order?
• Is there liability around opening my business during the pandemic?
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When should I resume operations and bring the team back to work?

You will need to make your own decision on whether to reopen and what types of patients and procedures to perform based on a variety of factors. We recommend following any local stay-at-home / shelter-in-place orders, as well as guidance from national/state licensing boards and associations and the CDC.

As of July 17, 2020, the CDC is recommending that healthcare facilities and clinicians:

• Be prepared to rapidly detect and respond to an increase of COVID-19 cases in the community.
• Provide care in the safest way possible.
• Consider that services may need to expand gradually.

The CDC provides a framework for provision of non-COVID-19 health care during the COVID-19 pandemic on their COVID-19 Guidance for Healthcare Employers page.

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What if there’s another stay-at-home order?

If you reopen and there is another stay-at-home order later that forces you to close again, then we can most likely expect to go through this process all over again. The good news is that you will know what to do this time.

If your stay-at-home order gets extended before you reopen, then it will be a simple matter of sending out another letter to your employees pushing back their start date or extending their furlough.

Click here to read more on instituting a temporary office closure.

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Is there liability around opening my business during the pandemic?

The straight answer to this question is, “Yes,” especially if you go against applicable recommendations and/or do not take the time to implement proper safety precautions.

For this reason, decisions to reopen should not be taken lightly. We highly recommend you take your time to inform yourself and prepare.

For more information, check out the video below on business liability during the pandemic from our Solution Center Manager, Grace Godlasky.

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Jump to a Topic:

• I can’t bring back my whole team right away, so how do I pick who I ask to return?
• What if I don’t want to bring someone back?
• What if an employee I ask to return to work requests paid leave under FFCRA?
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I can’t bring back my whole team right away, so how do I pick who I ask to return?

Whenever you are picking and choosing among your employees, you need to be careful that your decisions cannot be interpreted as discriminatory. This is why it is so important to make sure you have an objective reason for selecting specific employees over others.

The simplest objective reason is seniority. So, if you have three dental assistants and you only need one to start working again, then choose the one who has worked with you the longest.

Of course, things are not always this straight forward. Maybe your best dental assistant is the one you just hired. This is where documentation is so important.

Have you provided your other dental assistants with any corrective actions? Do you have any written proof that your newest dental assistant is your best performer? If not, then it could potentially be risky to hire her back first, especially if your other two assistants fall into some sort of protected class.

Given that cautionary information, employers should make the best decisions for their business and their patients and should do all they can to avoid making discriminatory decisions.

Be careful not to make assumptions about whether an employee wants to return to work or is available to return to work based on their personal circumstances or perceived health conditions.

So, if you know the employee has a disability, is pregnant, has children, or is the primary caretaker of an elderly parent, for example, do not make your decision about whether to ask the employee to return to work based on this information. Let the employee make this decision for her/himself.

To summarize:
DO: Have a clear, documented, objective reason for bringing back certain employees, e.g. seniority, performance, rate of pay.
DON’T: Base your decision on the personal circumstances of the employee.

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What if I don’t want to bring someone back?

Be cautious about using this as an opportunity to get rid of an employee you don’t want to keep as part of your team. If you don’t need to bring someone back, that’s fine. As we explained above, you may need to make some objective decisions about how to staff your office while starting a gradual reopen.

What you don’t want to do is tell an employee they are being permanently laid off because you no longer need them only to hire someone else to fill the same or a similar position within the next few months without offering the original employee an opportunity to return. That would not be viewed as a legitimate layoff but, rather, it would be seen as a standard termination, which we all know carries inherent risk. Many terminations are even riskier right now due to COVID-related employee protections.

Follow this rule: If you had ten employees before you furloughed your staff, then try your best to bring the same ten back. If you had ten when this all started and your business only needs eight for the foreseeable future, then make sure you don’t lean on any discriminatory criteria when it comes to choosing the eight you’ll keep.

If you want to let someone go due to performance reasons, then talk to CEDR about the situation first. If it is appropriate to let them go, be upfront about the reason. Don’t try to hide behind this situation and call it a “layoff” when it really isn’t. For more on this, we have a lengthier explanation on why employers should tell the truth when firing employees on our blog.

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What if an employee I ask to return to work requests paid leave under FFCRA?

Employees requesting paid leave under the Families First Coronavirus Response Act is a big fear among our members and for small businesses across the country. Of particular concern is the 12 weeks of emergency paid family leave available for employees who can’t work because they have to care for children whose schools or daycare facilities are closed due to the virus.

Understandably, after being closed with little to no revenue, the last thing you want is to have to pay employees not to work. We are here to tell you that this situation is much more manageable than you might think.

While you might actually be exempt from the requirements of the law, even if you are not — or if you choose to provide paid leave despite the exemption — you get a tax credit back for the paid leave you provide.

For more information about determining whether or not your employee is eligible for Emergency Paid Leave, as well as information about paying an employee during a period of quarantine check out How to Handle COVID Concerns in Your Office.

Jump to a Topic:

• Offer Letter
• Health Insurance
• Retirement Benefits
• Paid Time Off Benefits (vacation, sick time, PTO)
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Offer Letter

If you told your employees they were separated from employment, then you’ll need to notify them that you are extending an offer to rehire them.

If you are having regular check-ins with your team, then you can initially notify them through those meetings or emails. But just as with any new hire, it’s important to document the job offer. So, provide them with a written offer to rehire them, which can basically be a modified version of your standard hiring letter.

CEDR Members will find a letter to this effect pre-loaded in your HR Vault.

Not a CEDR Member? Sign up for a FREE HR Vault account to access a template letter and Re-Hire Checklist you can use to rehire your employees.

We also recommend informing them in advance about the various precautions you are taking to keep the team and your patients safe in the office. We’ve provided some ideas around this below.

As they are returning to work, you also need to attend to some hiring paperwork. Because this was a short lapse in service, your paperwork needs are slightly modified from the usual. We’ve prepared a Re-Hire Checklist which CEDR Members can access in their HR Vault.

If you’re not a member, Sign Up for Your FREE HR Vault Account to access that document.

This was a short break in service due to unique circumstances, so there is no need to go through many of your usual hiring processes. Please feel free to skip protocols you’d follow with a brand new applicant and hire — collecting applications and resumes, running background checks, and holding interviews.

You will need to make some decisions about employee benefits.

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Health Insurance

If you have a health insurance benefit and aren’t sure how to continue or reinstate it for your returning employees, you should contact your plan administrator for guidance on what to do. If you are interested in suspending the plan or making changes, discuss those topics with your administrator, as well.

If you were able to continue health benefits during the layoff period, then what you may need to do is collect the employee portion of those healthcare premiums if they didn’t submit payment for them during the layoff.

Some employers are choosing to cover those costs themselves, which is of course an option that’s open to you. Otherwise, you’ll want to calculate the total amount due to each employee and put something in writing to them about how those will be deducted from a series of upcoming paychecks.

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Retirement Benefits

If you have a retirement benefit plan and aren’t sure how to continue or reinstate it for your returning employees, you should contact your plan administrator for guidance on what to do.

If you are interested in suspending the plan or making changes, discuss those topics with your administrator, as well.

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Paid Time Off Benefits (vacation, sick time, PTO)

In general, employers have a lot of discretion when it comes to vacation benefits. Whether or not you reinstate vacation benefits to returning employees will depend on a variety of factors, including:

1. What your written policies say about this
2. Whether you can afford to maintain your discretionary paid time off benefits when you reopen.

If you laid employees off (i.e. officially terminated employment), then you could technically require employees to start from zero in terms of eligibility for vacation benefits, just like any other new employee (unless your written policies say otherwise). This isn’t necessarily advisable for obvious reasons related to team morale.

We would recommend reinstating any previously earned vacation that wasn’t paid out upon separation, or at least making these employees immediately eligible for any vacation benefits under your policies. But, you could explain (in writing) that employees will not be able to use their vacation benefits for the next couple of months or until further notice while the office re-establishes itself. Or, you can suspend vacation accrual moving forward until you can afford to reinstate your policy in full again.

Read more about other concerns around employees travelling for vacation during the pandemic.

When it comes to mandated paid sick leave benefits, make sure to follow any state or local laws in place because they will likely require reinstatement.

In any case, you should clarify any changes to benefits in writing from the start with your returning employees to avoid any misunderstandings.

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Jump to a Topic:

• “Come Back” Letter 
• Health Insurance
• Retirement Benefits
• Paid Time Off Benefits (vacation, sick time, PTO)
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“Come Back” Letter

If your team has been told they still have their job with you, and they are not getting any hours at the moment due to a furlough or temporary shutdown, then you’ll need to notify them that you are ready to start giving them hours again.

If you are having regular check-ins with your team, then you can initially notify them through those meetings or emails. But just as with any new hire, it’s important to document things in writing.

Provide them with a written letter that informs them of when you want them to return, their initial return to work schedule, and any changes in the office or their position that will be in place.

CEDR Members will find a letter to this effect pre-loaded in your HR Vault.

Not a CEDR Member? Sign up for a FREE HR Vault account to access a template letter you can use to notify your employees when you’re ready to bring them back to work!

We also recommend informing them in advance about the various precautions you are taking to keep the team and your patients safe in the office. We’ve provided some ideas around this below.

Since they remained your employees during this time, there is no need to go through any of your traditional hiring processes. However, employee tax withholding preferences may have changed since the employee last worked, so we recommend verifying the employees’ W-4 selections with them.

You will also need to make some decisions about employee benefits.

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Health Insurance

If you have a health insurance benefit and aren’t sure how to continue or reinstate it for your returning employees, you should contact your plan administrator for guidance on what to do. If you are interested in suspending the plan or making changes, discuss those topics with your administrator, as well.

If you were able to continue health benefits during the work stoppage period, then what you may need to do is collect the employee portion of those healthcare premiums if they didn’t submit payment for them during the furlough.

Some employers are choosing to cover those costs themselves, which is of course an option that’s open to you. Otherwise, you’ll want to calculate the total amount due to each employee and put something in writing to them about how those will be deducted from a series of upcoming paychecks.

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Retirement Benefits

If you have a retirement benefit plan and aren’t sure how to continue or reinstate it for your returning employees, you should contact your plan administrator for guidance on what to do.

If you are interested in suspending the plan or making changes, discuss those topics with your administrator as well.

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Paid Time Off Benefits (vacation, sick time, PTO)

In general, employers have a lot of discretion when it comes to vacation benefits. Whether or not you reinstate vacation benefits to returning employees will depend on a variety of factors, including:

1. What your written policies say about this
2. Whether you can afford to maintain your discretionary paid time off benefits when you reopen.

If you temporarily furloughed employees, you will likely want to honor any vacation that was earned prior to your closure, but you can suspend accrual moving forward until you can afford to reinstate your policy in full again. You could also explain (in writing) that employees will not be able to use their vacation benefits for the next couple of months or until further notice while the office re-establishes itself.

If you cannot afford to reinstate previously earned vacation, then make sure to check your state laws before you void these benefits as some states treat vacation as earned wages.

When it comes to mandated paid sick leave benefits, make sure to follow any state or local laws in place because they will likely require reinstatement.

In any case, you should clarify any changes to benefits in writing from the start with your returning employees to avoid any misunderstandings.

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Jump to a Topic:

• Find Out Why the Employee Is Concerned
• What if an employee doesn’t want to return due to a high-risk medical condition?
• What if an employee doesn’t want to return due to general COVID-19 concerns?
• What if an employee is unable to work due to lack of childcare?
• What if an employee doesn’t want to go off unemployment benefits?
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Find Out Why the Employee Is Concerned

First thing’s first: don’t make any assumptions about why an employee is hesitant to return to work. You should ask them to provide you with details, in writing, about why they are unable to return to work as requested, then respond to them accordingly.

You may be able to provide additional information that eases the employee’s concerns, or identify some additional measures you can take to resolve the issue. It may turn out to be an easily resolved issue, such as giving them a few extra days to set up childcare or reassuring them about the extra safety precautions you are taking in the office.

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What if an employee doesn’t want to return due to a high-risk medical condition?

If an employee has heightened health risks that make them uncomfortable with working in the office, we recommend being sensitive to this. Even if your state has said you can reopen, there is still a pandemic going on and those health risks are not gone.

You will want to go through an interactive process with the employee, just like you would in any other situation where the employee has medical concerns or restrictions, to determine if there’s a reasonable accommodation that would enable them to work.

You are likely already putting social distancing protocols in place, in general, but some specific areas that may benefit someone with a serious health condition include:

• Reduced contact with others through separated workstations
• Making hallways one-way
• Installing plexiglass or other barriers
• Wearing protective gear (gowns, gloves, face masks, eye protection)
• Using an air purifier

Work with the employee to find out if there’s anything you can do to make them feel safer coming to work. Other accommodations may include temporary job restructuring, which is happening in many workplaces right now anyway as businesses adapt to what’s going on. Job-restructuring options include:

• Removing marginal job duties that involve more exposure
• Temporary transfer to another position that has less patient contact
• Modifying the work schedule to reduce exposure while in the office or commuting to work

If coming into the office does not seem feasible, consider whether they would be able to perform remote work for you, such as billing, answering calls, etc.

Finally, just like in “normal” circumstances, a leave of absence may be considered a reasonable accommodation. Go through your normal leave of absence processes laid out in your handbook to document this with the employee and plan for regular check-ins with the employee to see if their ability to work has changed.

We know that having staff that is unwilling to work can be extremely frustrating and may create difficulties in staffing your office. But you also don’t want to create an increased risk of liability by requiring someone with a serious health condition to come to work. And the EEOC has reminded employers that protections for employees with disabilities are still in place during this time.

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What if an employee doesn’t want to return due to general COVID-19 concerns?

Generally speaking, an employee saying, “I am afraid to come to work and don’t want to return until I feel it is perfectly safe,” is not a reasonable request. If an employee’s objection to working seems to be going down that path, please refer back to the beginning of this section and ask the employee to provide you with their specific concerns.

You need to make sure that they don’t have a personal medical concern based on an underlying health condition, and that they don’t have a specific concern about an area of workplace safety in your office.

If they’re identifying a health concern, go back to the section of this blog covering employees with high-risk medical conditions above for what to do. If they have a specific safety concern, engage with them on that topic to assess if it’s a legitimate concern and how you can resolve it.

In the end, if this is just a generalized feeling of not wanting to work until the pandemic is over (which is unlikely to be any time soon), then you are able to treat it as a resignation. The employee is telling you that they are not available or willing to work.

A big caveat here. If you know that the employee has a preexisting mental illness or disorder, you may need to look at this differently. The EEOC has advised:

Although many people feel significant stress due to the COVID-19 pandemic, employees with certain preexisting mental health conditions, for example, anxiety disorder, obsessive-compulsive disorder, or post-traumatic stress disorder, may have more difficulty handling the disruption to daily life that has accompanied the COVID-19 pandemic.

As with any accommodation request, employers may: ask questions to determine whether the condition is a disability; discuss with the employee how the requested accommodation would assist him and enable him to keep working; explore alternative accommodations that may effectively meet his needs; and request medical documentation if needed.

The pandemic environment is causing heightened stress and anxiety in many people, but it can be a very serious, even disabling, matter for someone already dealing with a mental health issue. As always, you need to treat a mental health condition in the same way you would a physical one.

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What if an employee is unable to work due to lack of childcare?

Unfortunately, this is a very real issue for many parents right now, and in some cases simply won’t be a hurdle they can overcome. Schools, summer programs, camps, and daycares are closed and finding someone to care for children during this pandemic is extremely difficult for a lot of people.

Talk with your employee about what availability they have, if any, to come into the office or to work from home. You may need to be a little creative in order to find solutions that you normally may not allow, and trying to help a parent get back to work while their kids are home is where a lot of that problem-solving will come into play.

If it’s not feasible for them to work at all for the foreseeable future, but they are committed to returning to work as soon as they’re able to do so, we recommend allowing them the time off they need.

If the employee is not eligible for paid family leave under FFCRA (see above), you can call it a furlough extension or an unpaid personal leave of absence. Set an expected return date in writing and have them check in regularly with you about their status and efforts to come back to work.

Many employers are going to be tempted to consider this situation a resignation or a reason to terminate. We do not recommend doing that.

Your next steps would be to rehire for that position. The discrimination laws have not changed — you can’t screen out candidates who have children or disabilities, so you may find a new employee who very quickly ends up having a similar issue related to being able to work. As things settle down, it’s often in your best interest to still have your original employee ready and waiting to come back to work.

There also may be some risk in separating from an employee who is unable to work due to childcare at this time. Their inability to work could qualify them for paid leave under the FFCRA. Even if you are claiming an exemption from that law, we think there could still be risk around terminating someone who would be protected under that federal law.

Of course, the final decision is up to you and you may choose to separate this individual from employment. Be aware that under the federal unemployment expansion, this employee may still be eligible for unemployment even though you’ve made work available.

Unemployment is available if “a child or other person in the household for which the individual has primary caregiving responsibility is unable to attend school or another facility that is closed as a direct result of the COVID-19 public health emergency and such school or facility care is required for the individual to work.”

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What if an employee doesn’t want to go off unemployment benefits?

We’ve heard reports of employees who do not want to miss out on receiving their state unemployment benefit plus the additional $600 that’s being provided through the federal unemployment expansion.

Those supercharged benefits expire July 31, 2020. A lot of employees do not understand that this unemployment benefit increase is very short-term, and having ongoing employment is, in the end, much more valuable.

Because there is so much concern around this, we’ve published a blog dedicated to the subject.

Read “Handling Employees Who Refuse Work to Stay on Unemployment”

Note that, if your employees are refusing to work in favor of unemployment, you do not need to go out of your way to see that they are “kicked off” of benefits. Your state will have a process for certifying eligibility for unemployment benefits and, once they are no longer your employee, your state’s unemployment office will likely be in touch with you regarding your role in the reporting process.

CEDR Members: We have a sample letter you can use to address this situation, specifically. To access that letter and receive guidance on how to use it, contact the HR Solution Center.

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Jump to a Topic:

• Can I change hours, pay rate, and job duties?
• How does part-time work impact unemployment benefits?
• Paying Salaried Employees with Reduced Hours
• Paying Associate Doctors with Reduced Hours
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Can I change hours, pay rate, and job duties?

Yes, you can run your business in the manner that you need to in order to open back up and get back on your feet. This could include reduced hours, benefits, and changes in job duties. These changes should be communicated in advance in writing, and your state may have specific notification rules for changes in pay. Please also note that several jurisdictions have mandatory paid sick leave laws which must be reinstated.

Likewise, if you are participating in a PPP SBA loan, there are specific rules regarding pay and benefits which you must comply with.

As always, be careful about picking and choosing which employees you apply these changes to — across-the-board cuts are generally your safest option. If you only reduce the pay, hours, or duties of certain employees, you definitely want to have a solid, documented, objective business reason for doing so.

Click here for more information related to Emergency Paid Sick and Family Leave.

Click here for more info on paying employees while they are quarantined.

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How does part-time work impact unemployment benefits?

Even if employees are working, if their hours have been significantly reduced, they may still be eligible for unemployment benefits. A determination of whether they are eligible for a full or reduced/partial benefit will be determined by the state.

Unfortunately, each state has their own criteria for this, so it’s not always easy to tell ahead of time how many hours an employee can work before the unemployment benefit is impacted. But, if the employee is receiving income from you, they will need to report it, and the state will determine if that adjusts the amount of UI they receive.

Note that you are not legally permitted to allow your employees to “volunteer” to perform work for your business so that they can continue collecting unemployment.

Employers are required to pay employees for time worked in accordance with their regular payroll schedule. Employees have no legal authority to waive that requirement. Even if the employee doesn’t want to be paid, you as an employer have an absolute legal obligation to continue abiding by employment laws.

We recorded this video on unemployment benefit eligibility if you’d like more information on how that works:

For more detailed information, read our blog on federal unemployment expansion. The expanded criteria for who is eligible for benefits lasts through the end of 2020, but the additional $600 per week payment only lasts through July 31, 2020.

Another option is to apply to participate in a work-share program, if one is offered in your state. Each program is different, but they are generally designed to allow employers to continue operating on a reduced basis while giving employees the ability to make up for some of their lost wages through unemployment benefits. Using these programs often makes it easier on both employers and employees to participate in unemployment benefits.

We are aware of the following states offering some type of work-share program: Arizona, Arkansas, California, Colorado, Connecticut, Florida, Iowa, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Hampshire, New Jersey, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Texas, Washington, and Wisconsin.

Click here for more information on unemployment benefits during the COVID pandemic.

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Paying Salaried Employees with Reduced Hours

If you have salaried employees who are working but have reduced hours, then your pay obligation depends on whether they are exempt or nonexempt.

If they are exempt salaried employees (typically a high level manager, not eligible for OT), then, with a few exceptions, they need to be paid their full regular salary if they perform any work during a workweek. However, if you know that hours will be significantly reduced for some time, you can move them into non-exempt hourly status.

Make sure to document the reason for the change in status, including any changes to the employee’s duties that justify the reclassification. Whenever you switch an employee from exempt to nonexempt and vice versa, you should always have a bona fide reason for doing so and the change should last for more than a couple of weeks.

If they are salaried but still non-exempt (clock hours, get OT), then you are only legally obligated to pay them for hours actually worked so you can also switch them to hourly or prorate their salaries in accordance with your written policies. Of course, they must be paid at least minimum wage for all hours worked

In all cases, employees should be provided with advance written notice of any changes to their rate of pay.

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Paying Associate Doctors with Reduced Hours

If your associate doctors are properly classified as employees, they are almost always going to be considered exempt employees. But as doctors, there are some different rules that apply to their exemption. So, the requirement we just discussed above about exempt employees receiving their full salary when working part time does not apply to your doctors.

Instead, how you pay them while working reduced hours depends upon your written compensation arrangements with them. You need to review your employment agreement, offer letter, commission structure, or other documentation to confirm these details.

Most of our members pay their associates through some type of collections or production commission structure. When that’s the case, you can typically continue to pay the associate based on those commissions. Where things may be different is when there’s a base pay, guaranteed pay, or salary in place. That’s where the wording of the compensation structure becomes particularly important.

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Jump to a Topic:

• General Guidance
• Remote Work Policies
• Federal Sick Leave Policy
• State/Local Sick Leave Policies
• Health and Safety Policies
• Time-Off Policies
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General Guidance

As an HR company that creates customized employee handbooks for our members, CEDR has received a number of requests to update handbooks in relation to the coronavirus pandemic. We are not recommending any changes to existing policies at this time, nor do we recommend adding coronavirus-specific policies to your handbook.

Most of the proposed policies would be short-term items that you’d only have to remove from your handbook later. Further, CDC guidance changes frequently, so it’s better to review recommended protocols at the time that an issue arises.

For these reasons, it’s going to be easier to communicate your coronavirus policies and protocols to your team as standalone guidance.

CEDR members have access to HR Software that allows them to distribute new training and guidance to employees in the form of digital memos. Employees can also sign off on those documents online. If you are a CEDR Member and you aren’t using our software, contact us for more information.

If you are not a CEDR Member, you can sign up for FREE Access to our HR Vault software, which is preloaded with a handful of forms and letters to help you reopen your office.

You’ll find our recommendations around a few policy topics we’ve received questions about below.

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Remote Work Policies

If you have employees working from home, it’s a good idea to have some written policies about expectations around their work hours, recording their time, privacy, and security. However, we expect remote work arrangements to be temporary and not necessarily part of your future operational practices.

Therefore, we recommend providing this as a standalone policy, separate from your handbook (CEDR Members can find this policy in your Members Area). You can easily share this electronically in your HR Vault and have employees electronically sign it.

If you are an HR Vault user and you need help locating and distributing this policy to your team, contact us for help.

If you have not yet signed up for your free HR Vault account, you can do so here.

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Federal Sick Leave Policy

While there is a new paid sick leave requirement under the Families First Coronavirus Response Act, this is only a temporary benefit that applies in very specific situations. Therefore, you do not need to add information about it to your handbook.

The government is also continuing to update its guidance around those benefits, so if a situation arises where a member of your team wants to use that time off, we’d recommend contacting us at that time so we can determine if those rules apply to you.

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State/Local Sick Leave Policies

Some states and localities have enacted their own emergency paid sick leave benefits in response to the coronavirus pandemic. Like the federal Families First Coronavirus Response Act, these are temporary benefits and therefore not something that you need to put into your handbook.

In addition, most of these laws do not apply to CEDR members due to the laws impacting only businesses of certain sizes and in certain industries. We are monitoring those to see if you need to add a new policy.

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Health and Safety Policies

We also know that many businesses are modifying how they handle allowing someone to work who may be sick, asking for doctor’s notes, and other similar health and quarantine measures.

It would be a good idea to put your new protocols and expectations in writing so they are clear for your team. We anticipate the CDC recommendations around this topic to continue to change, and for many of these new protocols to be temporary. Therefore, we recommend providing these policies separate from your employee handbook. For CEDR Members, this new policy will be pre-loaded into your HR Vault.

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Time-Off Policies

You may want to make some changes to how additional paid time off can be used or accrued for the foreseeable future. It’s critical to notify employees of those changes in writing. These will most likely be temporary measures, so again you can do this through an office communication memo rather than updating your standard time off policies in your handbook.

In addition, you may want to have restrictions in place about your ability to approve time off that involves the employee traveling out of the area. More on that here.

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Under the Families First Coronavirus Response Act, employers are required to post a notice of this paid sick leave law in a conspicuous place in the office where notices to employees are customarily posted.

Note that you are required to do this, even if you believe you would be exempt from providing paid leave under that law.

The Department of Labor has also released this FAQ on the notice. It explains that if you have any employees still teleworking, you can satisfy this requirement by emailing/mailing the notice to employees.

We’ve made this really easy for our Members by creating an electronic file sharing and communication system that allows you to electronically notice your employee of there being a document for them to review online.

Not a CEDR Member? Get FREE Access to our HR Vault Software!

While not required, you may also want to post some new health and safety posters that are specific to COVID-19:

• OSHA has released a Workplace Safety Poster
• The CDC has a webpage dedicated to downloadable educational materials, including posters and factsheets

The more you do to show your employees and patients that you are aware of and taking precautions, the more safe and protected they may feel in the office. This also helps to make clear to employees what your expectations are of them with respect to taking additional precautions.

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The answer is “No.” In fact, that kind of signoff could be used to prove that you knew the workplace was likely unsafe and yet continued to require employees to show up.

This applies to employees who you might consider to be at higher than average risk, as well, such as employees who you know to have compromised immune systems or those that are currently pregnant.

As an employer, it is your responsibility to offer all of your employees the opportunity to resume work in a consistent manner, and then allow them to raise their own concerns about returning, should they see the need to do so.

Trying to preempt those concerns and refuse to allow those employee to return to work can be seen as discrimination, and asking them to sign a waiver could leave your business vulnerable to claims of failing to create a safe work environment.

Our guidance here is that you do everything you can to stay abreast of and follow the guidelines for treatment protocols as set forth by the CDC, OSHA, your governing body, and all federal and state authorities, while also staying on top of your worker’s compensation carrier’s latest guidance.

Grace Godlasky, our Solution Center Manager, explains the liability associated with staying open despite official orders in this video.

If you want to reduce your liability, then be sure you are following all official guidance and recommendations. If your governor or anyone else in a place of authority says “Emergencies Only,” then follow that guidance. If they say “Close,” then close. But, MOST IMPORTANTLY, document your efforts to comply with the rules.

Go over any concerns from your team each morning before opening and document what you did to address those issues. You’ll want to be able to show that you are constantly learning and updating your team’s knowledge when it comes to addressing safety in the workplace. OSHA requires you to maintain a safe and healthy workplace — your employees cannot release you from that responsibility.

We also want to also address a related question — should you have your patients sign this type of documentation? Since we are an HR company, we aren’t able to advise you on how to handle your patient communications. The ADA and the AMA have published their own resources on this topic.

Jump to a Topic:

• General Guidance for All Employers
• Guidance for Dental Practices
• Guidance for Medical Practices
• Additional Recommendations for Health and Safety Policies

We highly recommend reviewing and following guidance provided by the CDC and your industry boards and associations to ensure that you are providing a safe place for your employees to work in, and for your patients to return to.

Here are some specific resource links from OSHA, the CDC, and for dental and medical practices:

All companies should be following this guidance:

• OSHA Preparing Workplaces for COVID-19
• CDC Interim Guidance for Businesses and Employers to Plan and Respond to COVID-19
• OSHA: Ten Steps All Workplaces Can Take to Reduce Risk of Exposure to COVID-19
• OSHA Enforcement Guidance for Recording Cases of COVID-19

Dental Practices should follow this guidance:

• CDC Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19 Response
• ADA COVID-19: Frequently asked questions

Medical Practices should follow this guidance:

• AMA COVID-19: Frequently asked questions
• CDC Steps Healthcare Facilities Can Take Now to Prepare for COVID-19

Additional Recommendations for Health and Safety Policies

We are also providing some recommendations below that take into account protecting your employees as well as your patients. We know that every office can’t implement all of these ideas, and we also know that we can’t list every possible option here. But we hope this helps get you started as you look at what works for your individual business.

Engage in daily preventative measures to protect against exposure to coronavirus.

• Have everyone in the office wear masks, gloves, and gowns
• Make sure all surfaces and equipment are being thoroughly cleaned several times a day.
• Ask employees to change into and out of work clothes in the office. Where possible, launder their work clothes for them to ensure their clothes are being properly cleaned after each shift.
• Encourage covering your mouth when sneezing and coughing.
• Encourage employees to wash their hands and use sanitizer frequently.
• Install hand sanitizer dispenser stations or wipes throughout the office.
• Provide trash cans throughout the office so people can easily throw away gloves and sanitizing wipes.
• Increase ventilation rates and air circulation.
• Avoid nonessential business travel.

Inventory the common surfaces and shared items in your office and determine what you can do to limit multiple people touching the same items.

• Make sure each employee has their own workstation so they are not sharing computers or other equipment.
• Use CEDR’s PTO & Time Tracking system and enable permissions for employees to clock through their cell phones so they aren’t sharing devices in the office to clock their time.
• Remove unnecessary shared materials (waiting room magazines and brochures, pens, etc.).
• Remove waiting room chairs, or rearrange them so there’s at least 6-feet of space between each chair.
• Prop open doors so no one has to touch door handles or door plates to open and close your doors.
• Disable hand blow dryers and provide single use paper towels.

Consider how you can limit the number of people in the facility at the same time.

• Reconfigure patient appointment scheduling to limit the number of patients in the office at the same time and to allow time for cleaning.
• Prepare your patients for their visit — discourage bringing someone with them, recommend arrival times and educate them if you plan to take extra precautions such as waiting outside or asking them to wear a gown or mask.
• Have patients wait in their vehicles until you’re ready for them, then take them directly to the operatory or treatment room.
• Lock the front doors, post a sign telling the public you are “Open by Appointment Only” and instructing patients how to check in for their appointment (call from their car, ring a doorbell, etc.).

Limit face-to-face exposure. Help your team continue with social distancing measures while in the office and limit the need to gather in groups.

• Stagger start times so everyone is not arriving at the same time.
• Stagger lunch break times.
• Eliminate the need to gather together in a small room for a meeting. Spread out for your morning huddle, or communicate a different way so you don’t have to gather in close groups:

• Send a memo or electronic announcements in the HR Vault.
• Have a video conference with everyone spread out at their separate workstations.
• Make announcements over the office intercom system as staff are setting up for the day.

• Limit the number of staff members that need to interact with each patient.

• Check patients in over the phone.
• Move check-in procedures to a tablet or computer that gets sanitized after each person, rather than multiple people passing around paperwork.
• If you need your patients to check in at your reception area, see if you can install a physical barrier such as plexiglass.

• Limit the number of staff members that need to interact with each other.

• Completely separate your clinical and non-clinical teams. They may be able to work different shifts, or work in separated areas. For example, if you are limiting the number of patients you see, you may have some available rooms that you can temporarily repurpose for non-clinical workspaces.
• Split your teams so that you don’t have an entire department working at the same time. If you have four assistants, only have two in the office at a time and keep the grouping the same. That way, if one of them gets sick, you reduce the risk of them infecting the entire assistant team.

Develop an employee screening procedure, to check for coronavirus symptoms before they start work each day.

There’s already a lot of guidance out there suggesting that you check employee temperatures at the start of the day. While this is something you can do, we want to make sure that you’re doing it the right way.

Normally, checking an employee’s temperature would violate the Americans with Disabilities Act. But when a situation has been officially classified as a pandemic, the EEOC loosens up a number of restrictions to allow businesses to follow guidance coming from the CDC.

The CDC is now recommending monitoring the temperature of healthcare professionals, and the EEOC has indicated that they agree this is permitted right now. The EEOC has affirmatively stated that this is currently permitted.

It’s critical that you are consistent and objective about your screening process so you don’t raise concerns about discrimination. We highly recommend running through each of the following criteria to define the screening protocols you will be following:

1. Who is going to be screened. You may choose to screen all employees or only certain departments, such as those providing direct patient care. If you want to screen visitors, customers, patients, be sure you’re following your industry recommendations.
2. Who will perform the screening. Due to privacy concerns, be careful about who will be conducting the screening. Ideally it would be a manager, who is already trained on the importance of keeping employee medical information confidential. To ensure consistency in your processes, it would also be ideal for the screener to be the same person each day. Of course, also have a plan in place for the screener to go through the same process.
3. What equipment is needed. Make sure that the person conducting the screening has appropriate PPE. They will be coming into contact with each person arriving at the office, so you want to ensure they’re protected in case someone does arrive while they’re sick. Make sure they have a workstation set up that allows them to be at an entrance with easy access to everything they need. Decide what type of thermometer you’re using, as well as the protocol for cleaning it between uses.
4. Where the screening will take place. You want to be screening to limit unnecessary exposure, so you may want to do this outside or right at the entrance. If you have multiple entrances, you may want to designate one for employees only. If there is more than one person waiting, make sure you have space for them to be appropriately distanced.
5. Document consistently. The EEOC requires that any medical information you obtain about your employees be confidential.
6. What you are screening for. This probably seems obvious, but it’s crucial that the person conducting the screening has clear, objective criteria that they are looking for. If you are checking for fever, determine what temperature is an issue. If you are asking screening questions, ask each person the very same questions — Have you travelled recently?; Do you have any reason to believe you have been exposed?; Are you experiencing any symptoms of acute respiratory illness (e.g., fever, chills, cough, shortness of breath, difficulty breathing, sore throat)?
7. What happens if someone may be sick. You need to be clear and objective about how you’re using the information gathered from the screening process. Both the CDC and EEOC are saying you can send people home if they have COVID-19 symptoms (e.g., fever, chills, cough, shortness of breath, difficulty breathing, sore throat), so this is likely what you will be doing. But, again, you need to be completely consistent with how you treat each employee.
8. Employee communication. Make sure your employees know what you are doing, and that they will be paid for their time going through the screening process. They should know that they will be sent home if you have cause for concern, and understand what the procedure is for returning to work.