OSHA's Emergency Temporary Standard (ETS) Update

by Mark Harrison

On June 10, 2021, OSHA (the U.S. Department of Labor’s Occupational Safety and Health Administration) released the COVID-19 Emergency Temporary Standard (ETS).  This establishes new mandatory requirements, applicable to the healthcare industry.  SARS-CoV-2, the virus that causes COVID-19, presents “a grave danger” to workers in healthcare settings according to OSHA.  Since people with COVID-19 are reasonably expected to present themselves in this setting, the ETS was issued to address this hazard.  The full text of the ETS can be found at www.osha.gov/coronavirus/ets.  Refer to 29 CFR 1910.502.  

This rule applies to all settings where healthcare services or healthcare support services are provided and where suspected or confirmed COVID-19 patients are treated.  This includes employees in hospitals, emergency responders, nursing homes and assisted living facilities, home healthcare workers, and in ambulatory care facilities.  There are however certain enumerated exceptions.  The ETS does not apply to the following healthcare settings:

  • First aid performed by an employee who is not a licensed healthcare provider.
  • Pharmacists in a retail setting.
  • Non-hospital ambulatory care settings where non-employees are screened for suspected or confirmed COVID-19.
  • Hospital ambulatory care settings where employees are fully vaccinated and non-employees are screened prior to entry.
  • Home healthcare settings where employees are fully vaccinated and non-employees are screened prior to entry.
  • Healthcare support services not performed in a healthcare setting, i.e., offsite laundry offsite medical billing.
  • Telehealth services performed outside of a setting where direct patient care occurs.

According to OSHA, “For healthcare settings embedded in nonhealthcare settings, the ETS applies only to the embedded healthcare setting and not to the remainder of the physical location. Where emergency responders or other licensed healthcare providers enter a non-healthcare setting to provide healthcare services, the ETS applies only to the provision of healthcare services by that employee. The ETS exempts fully vaccinated workers from masking, distancing, and barrier requirements when in well-defined areas where there is no reasonable expectation that any person with suspected or confirmed COVID-19 will be present.”

If your setting is covered under the ETS, the following is a brief listing of the key requirements.  Consult the standard for full details.

  • Develop a COVID-19 Plan.
  • Patient Screening and management, limiting access to where direct patient care is provided.
  • Standard and Transmission-Based Precautions, following CDC guidelines.
  • Personal protective Equipment (PPE), ensuring appropriate use by employees.
  • Limiting the exposure to aerosol-generating procedures on a person with suspected or Confirmed COVID-19.
  • Physical distancing and install physical barriers at fixed work locations in non-patient care areas.
  • Cleaning and disinfection, following the CDC guidelines.
  • Monitor ventilation systems.
  • Conducting regular health screening of employees, report any positive cases of COVID-19.
  • Vaccination, reasonable time and paid leave for vaccination and vaccine side effects.
  • Training.
  • Prohibition on retaliation.
  • Requirements must be implemented at no cost to employees.
  • Recordkeeping, COVID-19 log (only required if more than 10 employees).
  • Reporting COVID-19 fatalities and hospitalizations to OSHA.
  • Mini respiratory protection program (29 CFR 1910.504), only under certain circumstances.
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