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COVID-19

Outpatient health care facility guidance

The following is intended as a plain-language summary of rules during the COVID-19 emergency and does not replace the need to follow all applicable federal, state, and local laws and regulations.

Protections Needed

Masks

  • Masking must be strictly observed, regardless of vaccination status. Ensure all persons (staff and patients) in the facility are wearing face masks.
  • Have front desk staff hand out masks to all patients who are not already wearing them on arrival.
  • Require everyone to remain masked at all times while on site except only:
    • When a physical exam procedure calls for mask removal.
    • As necessary for staff to eat or drink during breaktimes.
    • When in a break room or other area where patients are not present, and everyone is vaccinated.
      • The employee should be seated at least 6 feet from others when taking off mask.
  • Employers must provide appropriate PPE to workers, including surgical masks, face shields, and gloves.
  • Read more about PPE and infection control at the CDC website: Following Infection Prevention and Control Recommendations in Healthcare Settings During the COVID-19 Pandemic.

Barriers

  • Consider use of plastic barriers between staff, patients, and visitors where appropriate (for example check-in desks).

Isolate

  • Staff should be screened for symptoms before every shift and prevented from remaining on site if they have cough, shortness of breath, fever, chills, muscle pain, or new loss of taste or smell.
  • Employers may choose to use self-monitoring or in-person screening or both methods. For those who choose self-monitoring: supply employees with a short fact sheet to remind them of the symptoms of concern, and post a sign stating that any employee entering the workplace certifies that they do not have symptoms of COVID-19, reinforcing the obligation to self-screen before entering the workplace.
  • For those who choose to conduct in-person employee screenings: Ask the employee if they are experiencing symptoms consistent with of COVID-19. Employers should conduct this screening before employees meet others in the workplace, such as co-workers, patients, or visitors.
  • It is not necessary to conduct on-site temperature measurement for staff. If you measure temperatures, use a no-touch thermometer, and do not allow anyone with a temperature of 100.4 or higher to remain on-site.
  • Have sick leave policies in place so that employees excluded from the workplace do not lose earnings.
  • Health care providers and staff who are diagnosed with COVID-19 or have a probable case of COVID-19 (exposure and symptoms) should isolate and be excluded from work for 10 days since symptoms began. They may return to work if symptoms are improving, including being afebrile, for 24 hours without fever-reducing medications.
  • Those with severe to critical illness or are severely immunocompromised, should stay home from work for 20 days. Read more details in the CDC’s guidance on isolation duration.
  • Read further about when it is safe to return to work as described in Pennsylvania Department of Health’s Work Restrictions on Healthcare Personnel with Exposure to COVID-19.
    • If an employee develops COVID-19 infection or has a positive test, businesses and other organizations must take additional precautions to stop the virus from spreading further. Required precautions include calling the Health Department at (215) 685-5488 to report positive cases.

Reduce crowds

  • Ensure patients can maintain 6 feet during their visits, including in waiting areas.
  • Use floor decals or other visual cues to encourage spacing of at least 6 feet when patients queue to check in.
    • Consider changes to appointment scheduling to minimize numbers in waiting areas.
    • When appropriate, reduce in-person care and prioritize high-risk groups.
    • Consider using telehealth for screening patients for COVID-19 symptoms. Telehealth may be useful for screening and referring patients to appropriate care and managing less acute, non COVID-related issues. Follow CDC guidelines on Healthcare Facilities: Managing Operations During the COVID-19 Pandemic.
    • Consider how to gradually expand in-person clinical care services when appropriate.
  • Adjust work assignments to ensure employees can stay 6 feet from each other throughout their shifts when possible unless fully vaccinated.
  • Mealtimes are one of the most common sources of staff-to-staff transmission of COVID-19. Remind staff that they should limit the amount of time that they are not wearing a face mask and that they should continue to wear their face masks while in the break room when not actively eating.
    • Stagger breaks to minimize interactions among staff.
    • Space chairs in break rooms for staff to maintain at least 6 feet of distance during meals and when not eating unless everyone in the room is fully vaccinated.
    • Post signs alerting employees to maintain distance and avoid eating near or across from each other.

Handwashing

  • Place handwashing stations or hand sanitizer at office entry and outside bathrooms for all staff and visitors with prominent signage promoting use.
  • Emphasize importance of hand hygiene between each patient encounter for all staff.

Clean

  • Wipe down high-touch surfaces with disinfectant at least every 4 hours. See CDC guidance for details.

Ventilation

  • If possible, increase ventilation in the building by either:
    • Opening windows and/or doors on opposite sides of the building and using fans to blow outside air through the building OR
    • Optimizing ventilation provided by the heating, ventilation, and air conditioning (HVAC) system by:
      • Having the HVAC system checked to assure that it is working properly. If it can be adjusted, the system should be set to provide at least 6 air exchanges per hour.
      • Maximizing the amount of outside air circulated by the system.
      • Installing filters with minimum efficiency reporting values (MERV) of 13, or the highest compatible with the filter rack.
      • Checking that the external air inlet duct is not blocked and that it is at least 15 feet from people.

Communicate

  • Educate staff about symptoms and prevention of COVID-19.
  • Post prominent signs at entrances and in employee break rooms:
    • Asking people who are sick to call to notify staff before entering.
    • Encouraging people to cover coughs or sneezes.
    • Mandating physical distancing of at least 6 feet for both patients and staff whenever possible, including while queueing at check-in desk.
    • Mandating that all staff and patients wear masks.
  • Remind staff who are sick or have had close contact with someone with COVID-19 within the past 14 days to stay home and follow CDC quarantine guidelines​​​​​​​.
  • Staff who are diagnosed with COVID-19 should isolate and be excluded from work for 10 days since symptoms began. Read about how to make exceptions for extreme staff shortages (PDF).
  • Staff who have been fully vaccinated do not need to quarantine when exposed to someone with COVID-19 if they meet the following criteria:
    • They are fully vaccinated, and it’s been at least 2 weeks after the last dose in the vaccine series.
    • They have remained asymptomatic since the current COVID-19 exposure.
  • Vaccination is not 100% effective.
    • Anyone who develops COVID-19 symptoms should get tested. Refer to the PA Health Alert Network for more details.
    • Anyone who is positive for COVID-19 must isolate according to CDC guidelines.

Other

  • Encourage routine health maintenance and visits for care of chronic conditions, using telemedicine where possible.
  • Consider separate “sick” and “well” waiting room areas.
  • Consider separate office hours for sick visits and routine visits to help avoid transmission.
  • Promote routine and catch-up immunizations.

See also:

  • Text COVIDPHL to 888-777 to receive updates to your phone.
  • If you have questions, call the Department of Public Health at (215) 685-5488.

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