Bringing practice staff back from furlough safely: Adding the right protocols and education

MGMA Stat - May 14, 2020

Staffing Models

HR Legal

Policies & Procedures

Andrew Hajde CMPE
Veronica Bradley CPC, CPMA

The Medical Group Management Association’s most recent MGMA Stat poll asked medical practice leaders, “Have you implemented a plan to return furloughed staff post-COVID-19?” The majority (52%) responded “yes,” while 10% indicated “no.” Additionally, 38% of practices reported no staff had been furloughed.

The poll was conducted May 12, 2020, with 1,058 applicable responses.

Here’s what we learned from practice leaders who answered “yes”:
  • Many practices returned staff to work as soon as loan funds from the Paycheck Protection Program (PPP) were received.
  • Numerous practices have phased in the return of furloughed staff based on returning patient volume. Others are taking a tiered approach in 30-day intervals, and then planning for pro re nata (PRN) and locum tenens providers as needed.
  • Decisions on certain employees’ work schedules — such as medical assistants (MAs) — depend on in-office visits with patients reaching a certain volume.
  • In areas where elective surgeries were still prohibited, staff for surgeons were repurposed to help call and schedule primary care wellness visits. In areas where surgeries have resume, scheduler worked to bring down the waitlist of patients and get volume restored.
As medical practices begin reopening, it is important to know when and how your organization will address bringing back furloughed staff. The sudden effects of the COVID-19 pandemic left many healthcare organizations with diminished volumes and revenues, prompting the decision to furlough employees to avoid expansive layoffs. Those furloughs help to temporarily reduce payroll expenses while also reducing the angst of affected staff.  

Unfortunately, it doesn’t guarantee the organization will be able to keep valuable employees. Without pay, an employee might be inclined to search for a new job, resulting in the added expense of rehiring and training needs. As part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, if a business obtained a loan under the federal Paycheck Protection Program (PPP), there are requirements for the business to maintain or quickly restore staffing and employee salary levels to qualify for full loan forgiveness.

Find the latest regulatory and legislative updates in the MGMA COVID-19 Action Center
Click here to download a sample letter announcing practice reopening (MS Word)  

Considerations for bringing staff back to the office, post-furlough:  

  • What local guidelines need to be followed? 
  • Is the practice able to meet guidelines such as social distancing, use of personal protective equipment (PPE), cleaning, etc.? 
  • Is it possible to rotate shifts and extend office hours or have weekend hours to meet CDC guidelines for returning to work? 
  • Will it be a phased approach? If so, what will that look like? 
  • What staffing-to-patient volume is needed? 
  • Are there positions that can continue to telework while others return to the office? 
  • How will safety for both staff and patients be addressed? Has your compliance plan been updated? 
  • Due to the pandemic, what new labor rules do you need to know about? 
  • Will you be checking temperatures of employees? Who will do it? What are your new protocols? 
  • How will you handle those employees who may be at higher risk for severe illness from COVID-19 than others? 
  • How will you handle situations if staff do not want to come back at the time proposed? 
  • How will you handle the situation if an employee contracts COVID-19 while on the job? What needs to happen for the employee to return once he or she tests negative for COVID-19? 
  • What is your communication plan for employees and patients? 
  • How will you train your staff on new protocols and procedures? 
  • How will you keep morale up while knowing many providers and/or staff may still be afraid or have concerns? 

Ways to keep staff and patients safe 

Begin by having conversations with staff on implementing new policies and procedures in accordance with state recommendations, as well as guidance from the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO). The first day back will likely feel much different for everyone and people will need some time to adjust.  

  • Reduce the number of in-person patient visits
  • Offer telehealth visits
  • Stagger shifts, extend hours or offer additional hours on the weekend to spread out patient care visits
  • Reduce number of chairs in the waiting room and spread out chairs for social distancing
  • Have patients wait in their car till you call them in for their appointment
  • Add barriers such as plexiglass partitions between staff and patients when possible
  • Improve patient portal so that forms can be filled out online prior to visit
  • Postpone non-essential meetings or events in the office
  • Encourage non-essential people to drop off patients and wait outside until it’s time to pick up the patient
  • Encourage any vendors to deliver curbside and call the office when they arrive 

Employers need to remember it will take time to fully reopen and work up to pre-COVID-19 productivity levels. Identify any needed training and education on newly implemented or revised policies and procedures. Most importantly, employers should consider ways to boost morale since stress produced after unexpected time off can be traumatic. 

MGMA STAT 

Would you like to join our polling panel to voice your opinion on important practice management topics? MGMA Stat is a national poll that addresses practice management issues, the impact of new legislation and related topics. Participation is open to all healthcare leaders. Results of other polls and information on how to participate in MGMA Stat are available at: mgma.com/stat

Additional resources: 

About the Authors

Andrew Hajde
Andrew Hajde CMPE
Assistant Director, Association Content MGMA Englewood, Colorado

Veronica Bradley
Veronica Bradley CPC, CPMA
Senior Industry Advisor MGMA Englewood, CO

Veronica Bradley, CPC, CPMA, is a Senior Industry Advisor with MGMA and is CPC and CPMA certified. She has over 20 years’ experience in medical coding and auditing in various specialties. She is also well-versed hierarchical condition category and risk adjustment coding. Other areas of expertise include evaluation and management, procedural coding, Medicare reimbursement, and other critical factors in coding and auditing. Veronica has worked in private practice, group practices, academic school of medicine and hospitals. She focuses on educating based coding guidelines and code capture accuracy for all medical practice staff and believes coders must build rapport with healthcare providers to ensure healthy communication as necessary in the charge capture process.

Veronica received a bachelor’s degree from Regis University in Denver, Colorado in Health Information Management with a minor in Healthcare Administration. In her free time, Veronica appreciates spending time with her family enjoying the beautiful Colorado scenery.

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