Healthcare News & Insights

OSHA steps up scrutiny of inpatient facilities

The U.S. Department of Labor’s Occupational Safety and Health Administration has been scrutinizing the healthcare industry lately and what it found has the agency up in arms. So much so it introduced a new compliance nightmare for hospitals and nursing homes.


It’s simple. Inpatient healthcare settings consistently have work-related injuries and illnesses almost twice as high as the overall rate for private industry.

Expanded focus

Now, OSHA is expanding the focus of its inspections with a new healthcare enforcement initiative. It targets some of the most common causes of workplace injury and illness in the healthcare industry, specifically hospitals and nursing homes.

The focused is on:

  • musculoskeletal disorders related to patient or resident handling
  • bloodborne pathogens
  • workplace violence
  • tuberculosis, and
  • slips, trips and falls.

The memorandum “Inspection Guidance for Inpatient Healthcare Settings” from Dorothy Dougherty, OSHA deputy assistant secretary, provides guidance to federal OSHA regional offices and state plans for programmed and unprogrammed inspections.

The focus hazards listed above will be addressed in addition to other hazards that may be the subject of an inspection or brought to the attention of the compliance officer during an inspection.

OSHA hopes the new initiative will reduce overexposures to these hazards through enforcement, compliance assistance and outreach.

High-risk industry

Recent statistics show almost half of all reported injuries in the healthcare industry are from overexertion and related tasks. And nurses and nursing assistants accounted for a substantial portion of those injuries.

In 2013, U.S. hospitals recorded nearly 58,000 work-related injuries and illnesses, which amounts to 6.4 work-related injuries and illnesses for every 100 full-time employees.

“Workers who take care of us when we are sick or hurt should not be at such high risk for injuries — that simply is not right,” said Dr. David Michaels, assistant secretary of labor for OSHA, in a news release. “Workers in hospitals, nursing homes and long-term care facilities have work injury and illness rates that are among the highest in the country, and virtually all of these injuries and illnesses are preventable. OSHA has provided employers with education, training and resource materials, and it’s time for hospitals and the healthcare industry to make the changes necessary to protect their workers.”

In the memorandum OSHA pointed out that in regard to musculoskeletal disorders, between April 5, 2012 and April 5 2015 , 1,100 inspections of nursing and residential care facilities under the National Emphasis Program — Nursing and Residential Care Facilities (NH-NEP) were conducted. Of the 596 inspections which evaluated ergonomic stressors, 192 generated hazard alert letter to employers and 11 citation of OSHA’s general duty clause for hazardous ergonomic conditions.

Additional hazards

OSHA also advised compliance officers that when additional hazards come to their attention, the scope of the inspection may be expanded to include those hazards, which may include but aren’t limited to:

  • exposure to multi-drug resistant organisms (MDROs), such as Methicillin-resistant Staphylococcus aureus (MRSA), and
  • exposures to hazardous chemicals, such as sanitizers, disinfectants, anesthetic gases and hazardous drugs.

While there aren’t OSHA regulations for several of these hazards, compliance officers are advised to use the general duty clause. OSHA even included general duty clause citation language in the memorandum in attachment 3.

What to do?

Basically, any facility that provides residential or inpatient services can expect to get inspected by OSHA at some point in time. And that goes double for facilities with high work-related injury and illness rates. So just to be safe, it’s best to be ready.

To prepare for inspections, the National Law Review recommends inpatient care facilities immediately:

  • conduct internal OSHA compliance audits, but make sure to use outside counsel because audit reports prepared without outside counsel can be subpoenaed by OSHA
  • take time to thoroughly read the guidance memo, and
  • consult with counsel regarding OSHA inspection preparation.

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