OSHA inspections are honing in on health care

Nursing homes receive special emphasis

Seventy-three hospitals and 2,514 nursing homes have been notified that they are on a list for possible inspection because they have above-average lost-workday injury and illness rates. The health care industry, and particularly the nursing home industry, has been receiving increasing scrutiny from the Occupational Safety and Health Administration (OSHA). The agency announced a new National Emphasis Program for nursing homes that will result in unannounced, wall-to-wall inspections of 1,000 of those 2,514 high-injury facilities.

For the first time, OSHA also will include low-injury and -illness workplaces in its "site-specific targeting" inspection program as a way to gauge compliance with regulations. However, none of the 200 low-injury workplaces will be hospitals because the industry as a whole does not have a rate of eight or more lost-workday injuries and illnesses per 100 full-time equivalent workers.

The national lost-workday injury rate is three; hospitals have an average rate of 4.1. Nursing homes and personal care facilities have a rate of 7.9.

"When we visit a nursing home, we’re going to zero in on just the potential problem areas that result in the majority of injuries and illnesses among nursing home staff, such as ergonomics; bloodborne pathogens and tuberculosis; hazard communication; and slips, trips, and falls," John L. Henshaw, director for OSHA, said at the Applied Ergonomics Confe-rence held in Baltimore in March.

The National Emphasis Program reflects a growing scrutiny of nursing homes, which have among the nation’s highest injury rates. "We’re encouraged that now OSHA inspectors will actually be going into nursing homes and looking at some of the more significant hazards in these facilities," says Bill Borwegen, MPH, occupational health and safety director of the Service Employees International Union. Each year, OSHA reviews the lost-workday injury rates of about 1,000 hospitals, and keeps on its list those hospitals previously surveyed that had a rate of seven or higher. Hospitals with rates of 14 or higher will receive a wall-to-wall inspection, while hospitals with rates from eight to 14 receive warning letters and are placed on a secondary list for possible inspection.

OSHA determines its list of high-injury workplaces from a survey of 80,000 workplaces in selected industries. About 3,000 workplaces with injury rates of 14 or higher will receive the targeted inspections this year.