OSHA cites hospitals for recordkeeping flaws

Problems with forms top bloodborne lapses

Beware of recordkeeping violations. That's a word to the wise based on recent enforcement activity by the U.S. Occupational Safety and Health Administration.

In the last fiscal year ending Oct. 1, 2010, federal OSHA cited hospitals more frequently for failures related to the OSHA 300 log than any other standard. (Bloodborne pathogens came in second.)

Meanwhile, OSHA's pending new rule on recording of work-related musculoskeletal disorders would add a new requirement for employers to check a box on the OSHA 300 log indicating that an MSD occurred. It has been delayed due to an extended review from the U.S. Office of Management and Budget.

The proposed rule also removes the language in an OSHA compliance directive that says that "if a health care professional determines that the employee is fully able to perform all of his or her routine job functions, and the employer assigns a work restriction for the purpose of preventing a more serious injury."

"We're seeing them taking [recordkeeping] more seriously than they have [in recent years]," says Brad Hammock, Esq., workplace safety compliance practice group leader at Jackson Lewis LLP in the Washington DC region office.

Some common errors: Failing to post summary forms, improperly completing particular recordkeeping entries, not recording an injury or illness that should have been recorded, failing to have a proper signature on a form.

That increase in recordkeeping citations coincided with an OSHA national emphasis program on recordkeeping, which was announced in October 2009. The program focused on workplaces that reported low rates of injury that were in high-rate industries. Nursing homes were among the targeted employers, but hospitals were not.

Yet the increased scrutiny on recordkeeping may have been reflected in some hospital inspections, Hammock says.

"[OSHA is] citing employers for underreporting injuries and illnesses. That's a major problem because if hazards are underreported then there's no urgency to address them," says Bill Borwegen, MPH, health and safety director of the Service Employees International Union (SEIU).

Overall, hospitals typically do not receive many OSHA inspections relative to their workforce. Federal OSHA inspections overall rose by 5%, but declined in hospitals by about 7%, according to industry-specific OSHA data.

Yet that may change as well. In Fiscal Year 2011, OSHA included hospitals and nursing homes among the "high hazard" workplaces that are subject to unannounced, targeted inspections.

Hospitals that receive the targeted inspections have a rate of days away, restricted or transferred (DART) of 15.0 or more per 100 full-time equivalent employees or a case rate of days away from work due to injury and illness of 14 or higher. For nursing homes, the rates are somewhat higher, with a DART rate of 16 or above and a "days away from work" case rate of 13 or above.

In nursing homes, OSHA said it will focus on "ergonomic stressors; exposure to blood and other potentially infectious materials; exposure to tuberculosis; and slips, trips, and falls." Citations related to ergonomics would require use of the General Duty Clause, which requires employers to keep the workplace free of "recognized hazards that are causing or are likely to cause death or serious physical harm" to employees.

"OSHA will be doing more programmed inspections in the hospital sector, so it's good to know what OSHA is focusing on," says Borwegen, noting that OSHA is interested in recordkeeping and bloodborne pathogens.