OSHA bulletin clarifies hospital responsibilities for temp workers

Hospitals, temp agencies share responsibility

Hospitals that hire temporary workers share responsibility for their safety with the temporary staffing agency, according to a recent bulletin by the Occupational Safety & Health Agency (OSHA).

OSHA launched its Temporary Worker Initiative in April 2013 to address the growing numbers of temporary workers nationwide. It does not involve any new regulations, but emphasizes the joint responsibility shared by temporary staffing agencies and host employers, says Tressi Cordaro, JD, an occupational safety and health attorney with Jackson Lewis in Washington, DC.

"If you’re supervising on a day-to-day basis, you have always been required to record an injury or illness of a temporary worker," she says.

Safety training should be addressed in the contract between the temp agency and the employer, she says.

But even if the temp agency provides training, the host employer still has a responsibility to ensure that the temporary worker knows how to safely use devices and equipment, the location of chemical safety data sheets, and what to do if an injury occurs, she says.

OSHA’s new guidance calls the temporary firm and its client joint employers of temporary workers. Both bear responsibility for safety and health protections, but in most cases the host employer should record the injuries and illnesses of temporary workers on the OSHA 300 log, says the March 2014 bulletin on "Injury and Illness Recordkeeping Requirements," published online at https://www.osha.gov/temp_workers/OSHA_TWI_Bulletin.pdf. The bulletin is the first in a series of guidance documents issued under OSHA’s Temporary Worker Initiative.

Host employers are responsible for this recordkeeping if they supervise temporary workers on a day-to-day basis and when they control conditions that present hazards, the guidance says.

OSHA is taking a closer look at the balance of responsibility for temporary workers to ensure proper safety training is in place, says Stephen A. Burt, president of Healthcare Compliance Resources in Roanoke, VA.

"This recordkeeping [requirement] helps make hospitals responsible for all employees," Burt explains. "If you are responsible for creating a hazard, then you are responsible for seeing that anybody on the site is trained and has hazard awareness."

Staffing agencies typically are not able to provide adequate training, so this should be handled by the hospital, Burt notes.

It’s also the hospital’s responsibility to provide personal protective equipment to temporary workers, he says.

"If a temporary employee is injured at the hospital, the injury is reported on the hospital’s OSHA 300 log, not on the temporary agency’s log, Burt adds.

Host employers should communicate all information about injuries and illnesses with the staffing agency and establish notification procedures, OSHA states.

The OSHA bulletin does not address workers compensation claims and who pays for the injured employee’s treatment.

"The important part is determining who is responsible regarding worker’s compensation costs," says Dee Tyler, RN, COHN-S, FAAOHN, executive president of the Association of Occupational Health Professionals in Healthcare (AOHP).

Hospitals and staffing agencies need to address how injuries are handled in their contracts, and they need a plan for action in the event of a temporary worker’s injury on the job, Tyler says.

From the hospital’s perspective, follow-up of temporary workers post-injury is complicated, she notes.

"We often have challenges getting our own employees back for follow-up, so it’ll be a challenge for the occupational health professional," Tyler says.

Hospitals should at least notify the injured temporary worker and provide follow-up appointment information.

From the hospital’s perspective, the OSHA guidance offers a little clarity on an issue that they have dealt with for years. With both temporary workers and hospital volunteers, safety is an issue that needs to be addressed, Tyler says.

"A lot of health care facilities deal with this on an individual policy basis," she explains. "Some offer volunteers and agency workers a significant amount of health care screening, such as the flu vaccine if they offer it to their employees."

Other hospitals might refer temporary workers to the contracting agency or their personal physicians.

"OSHA’s bulletin makes it a little bit clearer for us about who would be responsible," Tyler says. "It reminds us to clearly make sure we spell out who is responsible — whether it is with training or education or a workplace injury. It needs to be addressed in a contract so when an agency staff person is injured, people know how to respond and what is expected of them."