Nursing homes dominate OSHA's hazard list

800 will receive comprehensive inspections

Twenty-eight hospitals and about 800 nursing homes will receive comprehensive inspections from the U.S. Occupational Health and Safety Administration (OSHA) because of high injury rates.

Nursing homes represent about 16% of the total high-hazard workplaces that have been selected for targeted inspection — and that is half of the number eligible for greater scrutiny. OSHA reduces the number of nursing home inspections by half because they would be overrepresented in the 5,000 inspections, explains Tom Galassi, MPH, CIH, deputy director of OSHA's Directorate of Enforcement Programs.

The high profile of nursing homes among high-hazard workplaces in the past is due to their overall number, says Dave Schmidt, chief of the division of data analysis. Some 17,000 of the 80,000 employers surveyed for the site-specific targeting program were nursing homes, he says.

But nursing homes also are hazardous because of resident handling injuries.

To be on the primary inspection list, employers reported a rate of 12 or more injuries or illnesses that resulted in days away from work, restricted work activity, or job transfer (DART) for every 100 full-time workers.

The DART rate for nursing homes is 6.3, compared to 2.6 for general industry. Sites on the targeted inspection list have a DART rate of 12 or higher or a "Days Away from Work [due to] Injury and Illness" rate of 9 or higher.

Since OSHA began using the general-duty clause — which requires employers to maintain a workplace free of recognized hazards that could cause serious harm — as an ergonomics enforcement tool, the agency has issued 16 citations. Ten of them were given to nursing homes; no hospitals have received a citation.

But according to Galassi, the enforcement actions and the targeted inspections, along with patient handling guidelines geared toward nursing homes, have led employers to respond to the hazard.

"We think we're getting some buy-in from the industry and recognition and agreement that resident handling problems can be addressed through engineering controls and work practices," he adds.