The Occupational Safety and Health Administration (“OSHA”) recently released new guidance regarding face coverings and respiratory protection for the long-term care industry during the COVID-19 public health emergency. This guidance is specifically aimed at skilled nursing facilities, assisted living facilities, and other long-term care facilities. It provides guidance regarding (1) the use of face coverings to reduce occupational exposure and transmission and (2) the use of respiratory protection in order to preserve the supply of N95 face masks.

OSHA recommends that in order to reduce potential occupational exposure and/or transmission of COVID-19, all workers in long-term care facilities should wear some type of face covering at all times while inside the facility. OSHA approved face coverings, which cover the nose and mouth, include: cloth face coverings, facemasks, FDA-cleared or authorized surgical masks, and respirators (including N95 masks). In the guidance, OSHA noted that each type of face covering provides different levels of protection from the basic source control of cloth face coverings to the protection against splashes and sprays of the FDA-cleared surgical mask to respiratory protection provided by the N95 filtering facemask respirators (“N95 FFR”). Accordingly, the guidance stresses the importance of selecting a face covering that is appropriate for the anticipated level of exposure to COVID-19. For example, workers that will be in close contact with a resident suspected of or confirmed to have COVID-19 must use an approved N95 respirator mask or equivalent.

In order to ensure respirators provide the necessary level of protection, long-term care facilities must use them in accordance with a respiratory protection program (“RPP”) (29 CRF 1910.134). The primary elements of an RPP include: assigning a trained program administrator to oversee the RPP; implementing detailed, worksite specific procedures for respirator use including medical evaluation, fit testing, and training; and a risk assessment to classify exposure risks for various types of workers. For further details regarding OSHA’s respiratory protection program, long-term care operators should refer to OSHA’s Small Entity Compliance Guide for the Respiratory Protection Standard, available here.

In addition to OSHA’s recommendation that all long-term care workers wear approved face coverings at all times within a facility, the guidance also addresses the importance of preserving the supply of N95 FFRs. Accordingly, long-term care operators are encouraged to adhere to the ‘hierarchy of controls’ which places a preference on engineering and administrative controls ahead of personal protective equipment. OSHA urges long-term care operators to continually reassess their engineering and administrative controls, such as ventilation, physical distancing practices, hand hygiene, and disinfecting surfaces, in order to identify improvements that will help avoid over-reliance on respirators.

Stotler Hayes Group continuously monitors recommendations and mandates for COVID-19 that impact long-term care facilities and will provide our clients with timely updates regarding same.