Staff Guide: Stop Legal Nightmares When Patients Refuse to Wear a Mask

The sad reality is your front desk employees are being forced to police your patients’ compliance with local, federal, as well as your own face mask mandates.

Arm your staff with the tools they need to be polite, uphold employment law, all while not violating the patient’s ADA rights. This guide walks you and your staff through overcoming the challenges of dealing with patients who refuse to wear face coverings.

Remain Courteous, No Matter What

Of utmost importance is that you remember that at all times you should be polite and respectful. Even if your patient is disrespectful or rude, you MUST be courteous and well-mannered.

It’s understandable that handling patients, visitors, and employees who don’t comply with healthcare preventive facial tools can really raise your ire. You may very well feel the urge to be curt or raise your voice. Avoid these gut reactions at all costs.

Advise Callers of Your Mask Mandate

An ounce of prevention is worth two pounds of a cure … You can eliminate any surprises by notifying patients upfront of your office’s policy.

Educate all staff who are answering calls and scheduling appointments to remind patients and visitors that your practice requires guests and employees to wear a mask. If they ask why, advise the following:

Stipulation: The practice is requiring that all employees, patients and individuals coming into our office wear a mask while inside due to safety concerns regarding COVID-19.
Reason: There may be employees, staff, patients or individuals in our office who have compromised immunities, which make this an even more important issue.

Ask Visitors to Don a Covering

If an individual comes in without a mask, ask: “Would you please put on a mask?”

In the event that the patient or visitor refuses to wear and mask, calmly tell a colleague to ring your supervisor, and politely inform the individual of the following:

Requirement: The practice is requiring that all staff, patients and visitors wear a mask while inside our office and when within six feet of others due to safety concerns regarding COVID-19.
Purpose: There may be employees, staff, patients or individuals who have compromised immunities, which make this an even more important issue.
Request: Ask the patient:

“Will you please put on a mask or do you need a mask?”

Query Refusers About Extenuating Circumstances

Before you jump to conclusions when a patient refuses to put on a mask, explore any associated concerns. Ask the individual, “Are you unable to wear a mask due to a disability?” Then depending on his response do this:

Negative response: Ask the patient again, “Will you put a mask on do you need a mask?”. If he still refuses, politely inform him:

“Sir, I’m sorry but unless you put on a mask, rules require that I ask you to leave. Please follow up with my manager at this number [provide contact name and number on a business card] so that you can receive services in an alternative way.”

Positive reply: Then politely inform the patient:

“Sir, thank you for advising me of the situation. So that we can best accommodate you, please contact my manager [provide name and number on a business card] regarding how you can receive services in an alternative way.”

Reminder: These are difficult times for everyone and everyone is under a lot of stress. As such, it is vitally important that you are polite and respectful in your interactions.

Defer Escalations to Your Supervisor

Despite extending your utmost courtesies, you may have instances in when the above steps do not diffuse the situation. If the patient argues with you or raises the concern that the mask request violates her rights under the Americans with Disabilities Act (ADA), kindly advise the patient:

“Mam, I understand your concerns. Please wait [in a designated location or open exam room], and a member of our management staff will be with you in a moment.”

Reference Legal Guidelines

To be prepared for facing such an intensifying circumstance, it’s a good idea to have a flyer printed and available that indicates the legal basis for your policy. Here is the exact language that indicates your practice’s healthcare requirement does not violate the ADA.

Official guidance: The ADA provides that nothing shall require an entity to permit an individual to participate in or benefit from the goods, services, facilities, privileges, advantages and accommodations of such entity where such individual poses a direct threat to the health or safety of others. 42 U.S.C.A. § 12182.

Based on guidance from the CDC and public health authorities as of March 2020, the EEOC has determined that the COVID-19 pandemic meets the direct threat standard.

Source: View the EEOC law regarding Pandemic Preparedness in the Workplace and the ADA at https://www.eeoc.gov/laws/guidance/pandemic-preparedness-workplace-and-americans-disabilities-act

For more practical strategies to head off face mask nightmares from labor and employment law attorney, Michael Wong, Esq.,, register for the online training, “Face Mask Policy Enforcement: Avoid Violations, Fines and Lawsuits.” He’ll walk you step-by-step through how to implement an effective face-mask policy that complies with the ADA, state and local mandates, and keeps your patients and staff safe.