With COVID-19 cases continuing to rise, the Occupational Safety and Health Administration (OSHA) has issued new respiratory protection guidance focused on protecting workers in nursing homes, assisted living and other long-term care facilities (collectively “LTCFs”).

OSHA’s new guidance stresses the significance of proper and effective Personal Protective Equipment (“PPE”) when dealing with COVID positive patients and residents, indicating that cloth facemasks and face shields are not PPE.

Most significantly, however, the guidance specifies that employees who are in close contact (less than 6 feet) with a LTCF resident with suspected or confirmed coronavirus infection must use a NIOSH-approved N95 filtering facepiece respirator or equivalent or higher-level respirator, as required by OSHA’s Respiratory Protection standard. Simply put, any staff (whether clinical or not) in close contact (less than 6 feet) with residents with confirmed or suspected COVID-19 likely need to be wearing an N95 mask. However, understanding the potential logistical challenges with obtaining N95s, OSHA indicates they will exercise enforcement discretion as it relates to N95 usage, but only if an employer can demonstrate and document good faith efforts to comply with OSHA’s requirements.

Finally, while the new guidance is heavily focused on respiratory protection, OSHA still takes care to reemphasize its traditional adherence to a “hierarchy of controls” to mostly protect employees working in LTCFs where COVID-19 may be prevalent, encouraging social distancing, good hygiene, implementing good ventilation systems and continuously disinfecting surfaces. OSHA continues to view PPE as the last line of defense, preferring traditional engineering and administrative controls to assist in protecting workers.