Skip to Content

Hospitals and Nursing Homes Beware: OSHA Announces New Enforcement Focus

on Monday, 29 June 2015 in Health Law Advisory: Zachary J. Buxton, Editor

On June 25, 2015, the Occupational Safety and Health Administration announced that the agency is expanding its use of enforcement resources in hospitals and nursing homes. The agency advised its staff through a memorandum that all inspections of hospitals and nursing home facilities, including but not limited to those inspections prompted by complaints, referrals or severe injury reports, should include the review of potential hazards involving musculoskeletal disorders related to patient handling; bloodborne pathogens; workplace violence; tuberculosis; and slips, trips and falls. While nursing homes have been the focus of heightened OSHA enforcement for several years, the new enforcement focus includes hospitals.

According to OSHA, U.S. hospitals recorded nearly 58,000 work-related injuries and illnesses in 2013, amounting to 6.4 work-related injuries and illnesses for every 100 full-time employees—almost twice the rate for other employers. Almost half of all reported injuries in the health care industry were attributed to overexertion and related tasks. Nurses and nursing assistants accounted for a substantial share of the total.

Earlier this year, OSHA released revised “Guidelines for Preventing Workplace Violence for Healthcare and Social Services Workers” (“Violence Guidelines”) and the “Hospital Respiratory Protection Toolkit” (“Respiratory Toolkit”). The Violence Guidelines suggest employers should adopt workplace violence policies, and it provides examples of situations the policies should cover and suggests content to include in the policies. The Respiratory Toolkit provides hospitals with guidance on how to develop and implement a respiratory protection policy, as required by regulation. Although both documents are advisory and not mandatory, employers should take care to comply with their recommendations in order to avoid a “General Duty Clause” citation from OSHA. This clause requires an employer to furnish a place of employment free from hazards recognized (by either the employer or the industry) to cause death or serious physical harm to an employee.

Hospitals and nursing homes falling under OSHA’s jurisdiction should prepare now for an inspection, as the agency does not give advance notice of when an inspection will occur. They should review the five hazards addressed by the Nursing Home National Emphasis Program (“NHNEP”): musculoskeletal disorders from lifting patients or residents; exposures to tuberculosis; bloodborne pathogens; workplace violence; and slips, trips and falls. They should also review the Violence Guidelines, Respiratory Toolkit, and all applicable OSHA regulations to ensure they are in full compliance. The Healthcare Section [https://www.osha.gov/SLTC/healthcarefacilities/index.html] of OSHA’s website is helpful in this regard. The use of self-audits and audits from safety consultants with health care industry experience is also a good idea. Such audits should be arranged by legal counsel so they are shielded by the attorney-client privilege and/or the “attorney work product rule” from being disclosed to OSHA.

R.J. (Randy) Stevenson

1700 Farnam Street | Suite 1500 | Omaha, NE 68102 | 402.344.0500