Attention Healthcare Employers: OSHA Issues Emergency Temporary Standard for COVID-19

June 21, 2021

The Occupational Safety and Health Administration (OSHA) issued an Emergency Temporary Standard (ETS) on June 10, 2021. The ETS applies to settings where an employee provides healthcare services or healthcare support services, with limited exceptions. Importantly, it exempts fully vaccinated employees from wearing a mask, physical distancing, and barrier requirements when the employer determines there is no reasonable expectation that any person with suspected or confirmed COVID-19 will be present.

Definition of Healthcare Services and Healthcare Support Services

Healthcare services are services provided to individuals by professional healthcare practitioners for the purpose of promoting, maintaining, monitoring, or restoring health. Professional healthcare practitioners include doctors, nurses, emergency medical personnel, and oral health professionals. Healthcare support services are services that facilitate the provision of healthcare services. These include, but are not limited to, patient intake and admission, patient food services, equipment and facility maintenance, housekeeping services, healthcare laundry services, medical waste handling services, and medical equipment cleaning and reprocessing services.

COVID-19 Plan

Healthcare employers must develop and implement a COVID-19 plan. The plan must be in writing if the healthcare employer has more than ten employees. The healthcare employer must conduct workplace-specific hazard assessment and include the input of non-managerial employees in the hazard assessment and development of the plan. The plan must:

  • Identify a workplace safety coordinator with authority to ensure its compliance>
  • Address the hazards identified in the hazard assessment>
  • Include policies and procedures to minimize the risk of COVID-19 transmission> and
  • Update the plan as needed to ensure its effectiveness.

Other Key Provisions

The healthcare employer must:

  • Provide patient screening and management, including limiting and monitoring points of entry> screening and triaging patients, visitors, and non-employees> and implementing patient management strategies in settings where direct patient care is provided.
  • Develop and implement policies and procedures to adhere to Standard and Transmission-Based Precautions based on Center for Disease Control (CDC) guidelines.
  • Provide and ensure employees wear a face mask when indoors and when occupying a vehicle with other individuals for work purposes, with limited exceptions.
  • Provide a sufficient number of face masks to employees and ensure each employee changes their mask daily, whenever soiled or damaged, and as necessary.
  • Provide and ensure employees use respirators and other PPE for exposure to a person with suspected or confirmed COVID-19 and for aerosol-generating procedures on a person with suspected or confirmed COVID-19.
  • Limit employees present during aerosol-generating procedures on a person with suspected or confirmed COVID-19 to only those essential> perform procedures in airborne infection isolation rooms, if possible> and clean and disinfect surfaces and equipment.
  • Keep individuals at least six feet apart when indoors.
  • Install cleanable or disposable solid barriers at fixed work locations outside of direct patient care areas where employees are unable to physically distance.
  • Clean and disinfect surfaces and equipment in in accordance with CDC guidelines in patient care areas, resident rooms, and for medical devices and equipment> clean high-touch surfaces and equipment at least once a day in all other areas.
  • Provide alcohol-based hand rub that is at least 60% alcohol or provide readily accessible handwashing facilities.
  • Ensure that employer-owned or controlled existing HVAC systems are used in accordance with manufacturer’s instructions and design specifications for the systems and that air filters are rated Minimum Efficiency Reporting Value 13 or higher, if possible.
  • Provide health screening and medical management, including:
  • Screening employees before each workday and shift>
  • Requiring each employee to notify the employer when the employee is COVID-19 positive, is suspected of having COVID-19, or is experiencing certain COVID-19 symptoms>
  • Notifying certain employees within 24 hours when a person who has been in the workplace is COVID-19 positive>
  • Following requirements for removing employees from the workplace> and
  • If there are more than ten employees, providing medical removal protection benefits in accordance with the standard.
  • Provide reasonable time and paid leave for vaccinations and vaccine side effects.
  • Ensure all employees receive training regarding COVID-19, tasks and situations in the workplace that could result in infection, and relevant workplace policies and procedures.
  • Inform employees of their rights to the protections required by the ETS and do not discriminate against employees for exercising such rights or for engaging in actions required by the ETS.
  • If there are more than ten employees, retain all versions of the COVID-19 plan implemented to comply with the ETS.
  • If there are more than ten employees, establish and maintain a log of all employee instances of COVID-19 without regard to occupational exposure and follow requirements for making the records available.
  • Report work-related COVID-19 fatalities and in-patient hospitalizations to OSHA.

All requirements must be implemented at no cost to the employee.


  • The ETS will be effective upon publication in the Federal Register.
  • Employers must comply with a majority of the provisions within 14 days, but they have 30 days to comply with the provisions involving physical barriers, ventilation, and training.
  • OSHA will use discretion in enforcement for employers making a good faith effort to comply with the ETS.

For additional information or assistance with drafting your OSHA COVID-19 plan, contact Mark Fahleson (, Tara Paulson ( or Jennifer Ralph ( >

This article is provided for general information purposes only and should not be construed as legal advice. Those requiring legal advice are encouraged to consult with their attorney.