Rearranging your practice during the current COVID-19 pandemic can be confusing, stressful, and even chaotic. Despite the rearrangement of staff and duties, your practice can keep staff safe while maintaining excellent patient care. In this post, we cover everything from government aid to paycheck protection to HR policies to protect your staff and colleagues during this uncertain time.
Important Items to Do Right Now:
- Make the switch to telemedicine, even if your office remains open. Isolation protects your patients and staff from spreading or contracting the coronavirus infection. Click here for all of PCC’s telemedicine tools and resources.
- Apply for an SBA loan, even if you think you don’t need it. Start here to begin applying for an economic injury disaster loan from the Small Business Administration. We’ll cover this process in more detail below.
- Be nimble. With the situation changing every day, it’s imperative to be agile in your business decisions and to continue to communicate well.
- Keep up to date with practice management advice from PCC’s Chip Hart and the Pediatric Management Institute’s Paulie Vanchiere with their webinar series. Sign up for the forum to be a part of the conversation and access the webinar materials here.
Applying for an SBA Economic Injury Disaster Loan
The COVID-19 Stimulus Bill (also known as the 2020 CARES Act) was passed into law on Friday, March 27th, 2020. This act allows businesses, which includes independent pediatricians, to apply for an Economic Injury Disaster Loan Emergency Advance. Small businesses may apply for this relief in order to receive up to a $10,000 advance. According to the SBA.gov website, “This advance will provide economic relief to businesses that are currently experiencing a temporary loss of revenue. Funds will be made available following a successful application. This loan advance will not have to be repaid.”
Eligible businesses include those under 500 employees and who were established after February 20th, 2020.
Paycheck Protection Program
Distinct from the SBA’s Emergency Advance from the Economic Injury Disaster Loan, the Paycheck Protection Program (PPP) is designed for businesses to pay their employees during this time of uncertain revenue. The PPP is a loan that is eligible to be forgiven by the SBA if the following criteria are met:
- Employees are kept on the payroll for 8 weeks
- At least 75% of the loan must be used for payroll
- Loan money is used for payroll, rent, mortgage interest, or utilities.
If criteria are not met, the loan has a maturity of 2 years and an interest rate of 1%.
You can apply for a PPP loan at any FDIC-insured institution. Here is a copy of the application to prepare for your application process.
Practice Management During a Pandemic
During their second webinar on March 27th, 2020, Paulie and Chip covered leadership strategies and advice to carry your practice through a time of crisis. Their first recommendation is to apply for the loans and government aid described above, even if you think you don’t need to or don’t qualify. Protecting your cash flow will be crucial in the weeks and months ahead.
While the financial preparations outlined above are important to keep your practice open and maintain yours and your staff’s paychecks, you will also need to maintain the safety and well-being of your staff during working hours. Here are some of the most common Human Resource questions to keep in mind during your pandemic response planning.
How can I keep the office safe for employees?
The Occupational Safety and Health Administration (OSHA) laws are those that protect employee’s safety at the workplace. OSHA and the CDC recommend the following methods, which protect employees by taking every precaution to prevent the spread of COVID-19:
- Prevention methods such as PPE -- these include mouth and nose coverings and eye shields. Standard precautions also apply, such as handwashing, separation of patients during triage, and isolating suspected or confirmed COVID-19 patients in a separate room.
- Restrict the number of people in a given area.
- Minimize aerosol-generating procedures (AGPs).
- Utilize safe work practices such as charting outside the treatment area, differentiating “clean” and “dirty” areas for replacing and putting on PPE, and maintain organized procedures for disinfecting surfaces, PPE, and other infectious materials.
- Maintain disinfection and sterilization procedures, outlined here by the CDC.
- Practices may also choose to triage patients in their cars or via telemedicine before treating them in person.
- PCC’s Chip Hart recommends considering giving employees options for telehealth, work from home, or non-punitive vacation leave for high-risk employees.
Advice from a pediatrician affected by COVID-19: “Assume you already have it and prepare accordingly.”
What should I do if someone in the workplace has a suspected or confirmed case of COVID-19?
- You should report a COVID-19 case of a patient or employee to local public health authorities. In addition, you should report an employee’s case to OSHA if the case was contracted at work or it is confirmed. See OSHA’s website for more details.
- According to the CDC, “Facilities and organizations providing healthcare should implement sick leave policies for HCP that are non-punitive, flexible, and consistent with public health guidance.”
- Someone with a suspected COVID-19 case (exhibiting symptoms such as fever) and those who had direct contact with that person should consider quarantine/self-isolation. Return-to-work protocols include lack of a fever for 72 hours and at least 7 days have passed since symptoms appeared.
Advice from a pediatrician affected by COVID-19: “Protect your staff, especially the clinicians. No docs means no patients.”
What should I do if I must lay off employees to pay the bills?
- Apply for the PPP if you haven’t already. This would provide you with 8 weeks of payroll protection.
- Consider a furlough (a temporary reduction in hours) or layoffs only if they are non-discriminatory. Exempt employees must be paid during any week they perform work-related duties.
- Employees who request time off to self-quarantine or care for a loved one may be eligible for FMLA.
- Consult your attorney for further details, and to protect the rights of your business and employees.
How should I lead my team and maintain communication during this time?
- Determine your organizational strategy. According to Paul and Chip, this may look like a democratic structure in which key members must have a say; a single person leader who organizes the team; or an “all must agree” system which requires unanimity before a decision is made.
- Determine a chain-of-command. If a doctor or partner is ill or cannot work, who will make relevant decisions? Plan accordingly, and repeat the process for all relevant staff (NPs, PAs, billers, reception staff).
- Determine your communication method and stick to it -- this could mean daily huddles over Zoom, staff-wide emails, and/or in-person check ins.
- Maintain morale. Your practice is working hard to maintain normalcy for kids and families in a time of crisis. Ideally, your new “normal” should do the same for employees. Consider how you can mirror the same routines of registration, triage, vitals, etc. to enable performance and maintain consistency.
Advice from a pediatrician affected by COVID-19: “Know your chain-of-command. Decide now who is in charge of what.”
Prepare for Recovery
Despite the constant shifting of needs and duties at this time, your practice should still be preparing for eventual recovery from this pandemic. Chip and Paul recommend a hard look at your patient recall system, as well-visits and vaccinations will likely surge post-pandemic, and staff will likely want to return to work and make up lost time and income.
For now, your practice can prepare for recovery by protecting your patients and staff from infection, preparing for cash flow and financial upsets, and making an adaptable plan for summer and fall well visits.
Make sure to join the COVID-19 Business Impact forum to stay connected with providers and experts on managing your practice, protecting staff, and maintaining excellent care for your patients. Together, practices can adapt and learn as the circumstances evolve, and continue to keep staff and patients safe and healthy.