During the first U.S. surge in COVID-19 infections, nursing homes, assisted living facilities, and other long-term residential care facilities experienced an especially high degree of workplace transmission of the virus and deaths. With infection rates again rising across the country, last week the federal Occupational Safety and Health Administration issued a temporary respirator guidance document intended to assist employers with protecting employees from workplace COVID-19 exposure.

The guidance, which does not have the legal effect of a formal OSHA safety standard, states that workers in these facilities should wear face masks at all times, including non-working time spent at the worksite. Employees who are in close contact with residents diagnosed or suspected of having COVID-19 must wear N95 or other NIOSH-approved respirators, as set forth under the OSHA respirator standard. This position conflicts with some early OSHA COVID-19 citations that required respirators even in the absence of close contact with infected persons. According to the guidance, the facilities should also implement other infection control measures, such as cleaning, ventilation, and social distancing requirements.

The guidance references a recent OSHA enforcement memorandum that directs compliance officers to show flexibility in situations where N95 respirators or fit testing equipment is not available. In another guidance document recently issued by OSHA, the agency called into question the effectiveness of N95 masks in filtering out the smallest of COVID-19 particles. Employers in these industries should review the guidelines and develop a written safety plan incorporating their recommendations.