The Law Offices of Cecilia Chen is honored to serve our dental clients and is deeply committed to the safety, compliance, and success of your dental practice during the COVID-19 pandemic.
As the facts and responses to COVID-19 (coronavirus) rapidly change, we would like to assuage any anxieties you may have and recommend possible plans of action for your dental practice to consider to weather this challenging time.
Keep Your Patients Informed
Patient communication is paramount to effective practice management. The unprecedented nature of this pandemic has provoked the spread misinformation, causing patients to react out of fear.
I recommend all practice owners to email or post on their websites to communicate the following to patients:
- Reduced or suspended office hours or services available;
- Your practice’s commitment to patient screening measures (such as temperature readings);
- Continued compliance with existing dental office sterilization procedures and requirements, which are in-place to combat diseases far worse than COVID-19;
- Your practice’s compliance with governmental and regulatory agency-issued COVID-19 response requirements for healthcare professionals; and
- Reliable and reputable resources your patients can reference which effectively and accurately describe the nature and impact of COVID-19 (such as this Key Facts Handout issued by the CDC).
COVID-19 certainly calls for caution and communicating the confidence your practice has with its compliance and preventative measures can mitigate the effect misinformation may have on your practice.
CDA Recommends Temporary Practice Suspension
On March 16, the California Dental Association recommended California-practicing dentists voluntarily take a 14-day suspension.
Though the decision of whether or not to close your practice is voluntary, we recognize that either choice presents significant legal and financial consequences.
Keeping Your Dental Practice Open
For practices that elect to remain open on a limited basis, it is imperative to be cognizant of mandatory compliance standards and to engage in patient screening measures and to minimize inter-patient contact.
Some suggested accommodations include:
- Conduct patient screening. When calling to confirm appointments, urge patients who are feeling unwell, exhibiting symptoms, have recently traveled to any locations with a Level-3 Travel Health Notice or believe they have been exposed to COVID-19 to reschedule. Before proceeding with an appointment, the CDA recommends dental professionals should include temperature readings as part of routine patient assessment and to take note if patients have fever, coughing, or shortness of breath.
- Avoid having patients in the waiting room. Instruct patients to check-in for appointments by calling the office from their cell-phones upon arrival. Patients without cell-phones should check-in with the office. If possible, have patients wait in their vehicles instead of the waiting room until the office notifies the patient via text message or phone call that they are ready to be seen.
- Limit practice visitors to patients only.
- Clean and disinfect public areas frequently. Pay close attention to those regularly-touched surfaces, items, and objects, such as chairs, door handles, and restrooms. The EPA has released a list of COVID-19-effective disinfectants. Be sure to confirm your chosen disinfectant complies with the infection control regulations of the state dental board.
- Promote hand hygiene and proper coughing and sneezing etiquette. The CDC has a wealth of health promotion materials available on its website, including hand hygiene and coughing and sneezing etiquette resources, such as posters and informational videos which can be displayed in the office and/or played on the reception-room television.
- Encourage employees with acute respiratory symptoms to self-quarantine. Employees appearing to be ill at the office should be separated immediately and sent home. Until the employee is symptom-free without the use of fever-reducing medication for a minimum of 24-hours, the employee should not return to work.
Closing Your Dental Practice
If you elect to temporarily close your office, here are some government assistance programs that are available to relieve some financial and employment concerns:
- Financial Assistance. Should you require financial aid to assist with practice operation, the U.S. Small Business Administration is currently offering disaster assistance loans to small businesses severely impacted by COVID-19.
- Tax Payment Extensions. As of March 17, filers can take an extra 90 days to both file their tax returns and to pay the IRS any amounts due without incurring interest and penalties. Additionally, the CA Franchise Tax Board announced that COVID-19 affected taxpayers will be granted an extension to file 2019 CA tax returns and make certain payments to June 15, 2020, for all tax filings and payments due between March 15, 2020, through June 15, 2020. Finally, employers experiencing COVID-19-related hardship can submit a written extension request with the EDD for up to an additional 60 days to file their state payroll reports and/or deposit state payroll taxes without penalty or interest. Note that EDD extension requests must be received within 60 days from the original payment or return delinquency date.
Employment Concerns
COVID-19 has implicated numerous employment-related issues, regardless of whether or not your practice temporarily closes or remains open.
- Sick Leave. Currently, federal and state law prevent employers from requiring their employee use their sick leave or PTO before paying that employee for time-off; this decision belongs to the employee. However, employers may require that the employee use at least 2 hours of sick leave, in the event the employee elects to use their sick leave. Employers should reference the CA Department of Industrial Relations’ Paid Sick Leave FAQ.
- School Closures and Childcare. In California, dental practices with 25 or more employees cannot discriminate against or terminate the employment of an employee who utilizes paid or unpaid time off for specific school-related emergencies –including civil authority’s closures of the employee’s child’s school or daycare. Such employees are entitled to 40 hours of leave annually. Whether or not that employee’s leave is paid or unpaid is specific to each practice’s existing leave, paid-leave, or vacation policies.
- Schedule Reductions. Should an employee require financial assistance due to reduced hours, that employee is permitted to apply for partial unemployment assistance with the EDD. Practice employers certify through Form DE 2063 – Notice of Reduced Earnings that the employee has experienced a reduction in hours and that the employee is expected to return.
Practice Sales and Purchases
If you are currently in the middle of buying or selling a dental practice, I recommend that you delay but not cancel your transactions due to profitability or production concerns caused by temporary office closures and/or appointment cancellations. A resumption of normal operation contingency can be added to the transaction to alleviate some uncertainty.
With practices electing to either limit services or close altogether and patients cancelling upcoming appointments prompted by self-quarantine measures, buyers and sellers alike are increasingly concerned with the stability of practice production levels.
However, it’s important to remember that once practices reopen, an increased influx of patients is anticipated, including both those patients who cancelled appointments and patients who avoided scheduling treatment in observation of quarantine recommendations.
Understandably, committing to a life-changing sale or purchase may currently feel ill-advised in this time of uncertainty. Nevertheless, it’s important to remember that these times are temporary –life will eventually and inevitably resume, with patients still requiring treatment and services from dental practices.
Consult Your Advisors
Owning a dental practice is a trying yet rewarding venture. This is a challenging time that we will all get through together.
Please contact our office with any questions or concerns you may have regarding your dental practice’s legal needs.