Alan A. Ayers, MBA, MAcc, is Practice Management Editor for JUCM, serves on the Board Directors of the Urgent Care Association of America, and is Vice-President of Strategic Initiatives for Practice Velocity.
Urgent Message: Every urgent care center should have a policy addressing the various issues of communication, safety, pay, operations, and human resources that will undoubtedly come up when bad weather strikes.
If the paradigm shift fueling the success of the urgent health-care model could be encapsulated in a single word, it would be availability. Whether it’s after hours or the weekend, affordable urgent care is imminently available, with health-care providers and their staff members treating minor medical conditions long after most primary-care offices have closed for the evening.
Despite that availability, however, even urgent care centers have to shut their doors early when the weather takes a turn for the worse. Heavy snowfall, flooding, high winds, torrential rain, and earthquakes can make conducting normal business impossible, posing a safety risk to patients and staff members. Thus, every urgent care center should have an inclement-weather plan, supported by a comprehensive written policy that details the following:
- The specific adverse weather conditions under which the center will be closed or open
- The procedures for notifying patients and staff members of a closure
- When it is both safe and feasible to reopen for normal business
- How to handle closure-related pay issues for exempt and nonexempt staff members and health-care providers
Who Makes the Call
Inclement weather is generally described as a weather condition that causes major blockages of roads and disrupts the operation of schools and businesses in the area. Bad weather can quickly make roads impassable, damage buildings, and cause widespread power outages.
Exactly who makes the call on closing an urgent care center will depend on the size and affiliation of the center:
- For larger urgent care chains, a weather-related closure will generally be an executive decision. Depending on the organization’s corporate hierarchy, the decision could come down from a regional director of operations, a business unit senior leader, or a human resources vice-president or director for the region.
- For smaller, independent centers, the medical director or owner–operator will make the call on when to close due to bad weather.
- In most—if not all—cases, the urgent care center’s leaders will closely monitor National Weather Service advisories, school-closing updates, news reports, and the announcements from local government authorities (particularly when they advise staying off the roads) for guidance when considering an inclement-weather closure. In the absence of definitive information, leaders should rely on their own best judgment.
Criteria for Closing
When determining if the weather conditions are adverse enough to warrant closure, urgent care center leaders should first ask the following questions:
- Are the roads closed, impassable, or extremely dangerous to travel on? If heavy snowfall, roads slick with ice, flooding, or some other weather calamity has made it unlikely that patients and employees can arrive safely, then the center should be closed.
- Has a regional weather disaster resulted in a power outage? Earthquakes, ice storms, and high winds from tornados, hurricanes, and tropical storms can knock out power to an entire grid, leaving most business establishments in the dark. Note: Consider investing in a permanently installed automatic generator fueled by natural gas so that the center can remain open even if electricity in the area goes out. A generator can pay for itself via revenue that would otherwise not be realized had the center closed. It can also protect patient samples and investments in inventory (including vaccines) by keeping refrigeration systems running.
- Have other weather-related complications made the center unsafe to open? For example, if the landlord or snow-removal contractor has yet to clear ice and snow from the parking lot, building overhangs, and walkways, then entering and leaving the building can be dangerous, exposing the center to injury lawsuits or workers’ compensation claims. In such a situation, the center should remain closed until all of those areas have been properly cleared.
During inclement weather, employees will need to know if they’re expected to report for their scheduled shift or if instead, the center opening has been delayed. Most centers use one or more of the following communication methods:
- A pyramid-shaped call tree or phone tree: The person at the top of the pyramid notifies two employees by phone, and then those two employees each call two additional employees, and so on, until all staff members have been notified. The order of this process should be clearly laid out for everyone.
- E-mail and text notification.
- Company website: Closure messages can be posted on the homepage of the center’s website, with additional employee-sensitive information posted on a private-access intranet.
- In the absence of electrical power, a battery-powered radio (or a smartphone, tablet, or laptop with remaining battery life) can be used to stay abreast of local weather trends. It could be that the power is out where the employee lives but is on at the urgent care center, or vice versa.
Paying Providers and Staff
Both nonexempt and exempt urgent care staff should have a clear understanding in advance of how payment issues will be handled during partial and full-day inclement-weather closures. The following general guides apply to most cases:
According to the Fair Labor Standards Act (FLSA) of the U.S. Department of Labor, nonexempt employees are entitled to overtime pay if they work more than 40 hours in a workweek. FSLA guidelines for paying nonexempt employees in an inclement-weather situation are as follows:
- Inclement-weather conditions that develop during business hours: If nonexempt employees are available for work but work is not available, they are not entitled to pay. They are paid only for the hours worked.
- Inclement weather that keeps the center closed for an entire day: Nonexempt employees are not entitled to pay in this situation. However, most companies will allow the use of paid time off (PTO) to compensate for the lost work opportunity.
- When the center is open for business but the employee cannot report to work on time because of a weather-related contingency: Employees’ child-care complications when schools are closed and transportation difficulties fall under this category. The FLSA states that employees will be paid only for the hours worked, regardless of whether they arrive late or leave early.
It should be noted, however, that many urgent care employers will still allow some combination of PTO and normal remuneration in inclement-weather scenarios even when FLSA rules do not require them to do so. The details of that combination depend on the human resources policies of the particular organization. It can only foster goodwill and improve employee morale when nonexempt staff members see that the center’s leaders recognize the unique circumstances presented by inclement weather and do the right thing by them.
Exempt employees are generally salaried employees, and thus they are “exempt” from receiving overtime. FLSA guidelines for exempt employees are as follows:
- Inclement-weather conditions that develop during business hours: Exempt employees cannot be denied pay when they are willing, able, and available for work. Therefore, exempt employees must be paid their regular salary for the entire day, regardless of the hours worked.
- Inclement weather that prevents the center from opening the entire day: Exempt employees must be paid their regular salary for the entire day, although the center may require that they use accrued PTO or vacation hours to cover the missed time.
- When the center is open for business but employees cannot report to work on time because of a weather-related contingency: If travel difficulties and/or child-care arrangements prevent employees from coming to work, the absence is categorized under “personal reasons” and the employees are not entitled to compensation. However, if such employees can work even a partial day—either coming in late or leaving early—they are entitled to a full day’s salary.
These guidelines apply to exempt employees for up to one week, after which they must use accrued PTO or vacation time if a regional weather disaster prevents the center from opening after a week’s time. Again, urgent care leaders who deviate from the hard-and-fast FLSA regulations by doing their best to ensure that everyone is compensated, one way or another, engender greater loyalty and employee morale.
Inclement-weather conditions have been known to spur increased visits to urgent care centers, for a variety of unique reasons besides the expected weather-related injuries and illness. Patients will need an easy way to find out whether the center is open for business, which can be communicated via the following methods:
- Prominent, well-lit drive-by signage that communicates “We’re open!” to the surrounding community when the center is indeed open
- An e-mail message to every patient on the center’s e-mail list
- A text message to every patient who has a mobile number on file with the center
- A post on the homepage of the center’s website
- A post on the center’s social media profiles: Facebook, Twitter, and others
- A recorded message on the center’s phone system
’Tis the season for wicked weather, so an urgent care center should definitely have a detailed inclement-weather policy ready to address the various issues in communication, safety, pay, operations, and human resources that will undoubtedly come up. An improperly handled weather closure can be fraught with all sorts of logistical and legal perils, so urgent care center leaders must ensure that the policy is well thought out and comprehensive.
With that comprehensiveness should also come a degree of flexibility, particularly in regard to FLSA pay rules. The laws regulating compensation for weather-related closures and their contingencies are clear, but each individual urgent care center retains the latitude to “do the right thing” for employees and their families. If this means providing a full day’s pay for a workday truncated by inclement weather, not pressuring staff members to brave dangerous conditions just to get to work, and giving special consideration to employees facing unexpected child-care arrangements, then so be it. These are fair and just practices that put real weight behind the urgent care concept of a “care team.”
Be prepared when bad weather strikes, and put the interests of your patients and staff members first. Your loyalty and consideration will be greatly appreciated, and when things return to normal, they will most likely be reciprocated.