OSHA Basics: What is OSHA

OSHA; Regulations
​​​In recent years, nursing homes and assisted living communities across the Unites States have come under increased scrutiny from the Occupational Safety and Health Administration (OSHA). OSHA, a branch of the Department of Labor, is the U.S. government agency tasked with enforcement of workplace safety, setting standards, conducting inspections, and promoting health and safety training for employees. OSHA has traditionally focused on high-hazard industries, like construction and manufacturing, but its attention has shifted recently to health care providers, including long term care (LTC) communities. 

While we are all familiar with how the Centers for Medicare & Medicaid Services (CMS) sets and enforces regulations in nursing homes and ID/DD communities for resident care, OSHA has its own set of regulations that should be considered as you update both resident and employee safety policies and procedures. It is also important to note that unlike CMS, OSHA has jurisdiction over and enforces standards for assisted living communities, as well as nursing homes and ID/DD. 

This article is the first in a series aimed at providing education about OSHA regulations in nursing homes, assisted living communities, and ID/DD to help prepare for a potential OSHA inspection. But first, it is important to understand why we are seeing more of OSHA and who the organization is.
High Injury/Illness Rates Mean More OSHA Attention
OSHA's increased regulation in health care is a direct result of public attention and employee illnesses during the COVID-19 pandemic. Bureau of Labor and Statistics (BLS) data shows public and private nursing homes had the second and fourth highest days away, restricted, transfer (D.A.R.T.) injury and illness rates of all industries during 2021. These high injury and illness rates are a primary trigger for an OSHA inspection and have resulted in substantial penalties over the last several years. 
OSHA and CMS Regulation Integration
While CMS surveys focus primarily on resident care, OSHA solely focuses on employee health and safety. But despite their distinct objectives, CMS and OSHA regulations overlap in many areas. Take infection control policies as an example. They are designed to safeguard resident health but also protect employees and cover a substantial portion of OSHA's bloodborne pathogen standard. Likewise, approaches aimed at managing resident behaviors not only fulfill the needs of CMS; they also align with OSHA's mandates to prevent workplace violence incidents involving residents and employees.

OSHA has certain separate requirements (which will be outlined in the series), but as you read through these articles, consider how your OSHA-based policies and your CMS-based policies can work together. The more integrated your policies, the lower the risk of conflicts between these policies. This framework not only ensures regulatory compliance, but will also likely result in a safer environment for both residents and staff members.

Going Forward
In the coming weeks, these articles will spotlight common violations, discussing one or two regulations each week. It is important to note that these articles should be informative and not intended to cause alarm. They will provide a general overview of compliance issues without covering every detail of OSHA regulations and employee safety. They should supplement – not replace – your regular policy-making process, whether managed internally, through outside consultants, or legal advisors. 

By staying informed and integrating these insights, nursing home, assisted living, and ID/DD operators can navigate the complex regulatory landscape, ensuring the well-being of both residents and employees within their communities.