Occupational Safety and Health Administration (OSHA)



Navigating OSHA Recordkeeping: Introduction, Insights, and NEW Regulationhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/Navigating-OSHA-Recordkeeping-Introduction,-Insights,-and-NEW-Regulation.aspxNavigating OSHA Recordkeeping: Introduction, Insights, and NEW Regulation12/1/2023 5:00:00 AM<p></p><div>Within long term care, where meticulous recording and documentation are routine practices, the analysis of both resident and employee events takes a central role. Employee injury and illness tracking is governed by the Occupational Safety and Health Administration (OSHA) under 29 CFR Part 1904. This article serves as the first installment of a <strong>two-part series</strong> on OSHA Recordkeeping. In this initial piece, we introduce the OSHA Standard and cover terms and key insights. The subsequent article will cover the new regulations set to take effect on January 1, 2024. </div><div><br></div><div><strong style="text-decoration:underline;">Introduction to Recordkeeping</strong> <br></div><div><br></div><div>At its most basic, the OSHA recordkeeping standard requires employers to keep data on and track each employee injury or illness. An employee injury or illness is generally “recordable” (i.e., must be included on your OSHA 300 and 301 forms) when it is work-related, is a new injury or illness, and results in medical treatment beyond first aid, days away from work, work restrictions, or a job transfer. There are also exceptions to the recordkeeping requirements, such as a cold or flu, which are covered in more detail below. The following is a brief list of common terms and applications of the OSHA Recordkeeping Standard.  </div><div><br></div><div><strong>1. Covered Employers:</strong> Most employers, including Long Term Care providers, with over 10 employees must adhere to OSHA's recordkeeping standard. There is, however, a <a href="https://www.osha.gov/laws-regs/regulations/standardnumber/1904/1904.1" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">partial exemption for employers with 10 or fewer employees​</a>.  </div><div><br></div><div><strong>2. Recordable Injuries and Illnesses: </strong>Employers must record specific work-related incidents, detailed in <a href="https://www.osha.gov/laws-regs/regulations/standardnumber/1904/1904.7" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">general recording criteria</a>, which includes but is not limited to, injuries that result in medical treatment beyond first aid, days away from work, work restrictions (like light duty), or transfer to a different job. “Work-related” means that an event or exposure in the work environment either caused or contributed to the resulting condition or aggravated a pre-existing condition.  </div><div><br></div><div>Common exceptions to work-relatedness include an injury or illness suffered when the employee was at the jobsite as a member of the public, like visiting a relative who is a resident, rather than as an employee, 2) symptoms that arise at work but are entirely due to an unrelated event, 3) eating, drinking, or preparing food for personal consumption, and 4) the common cold or flu. The entire list of exceptions is available <a href="https://www.osha.gov/laws-regs/regulations/standardnumber/1904/1904.5" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">here</a>. </div><div><br></div><div><strong>3. Forms:</strong> Three forms—Form 300, Form 301, and Form 300A—must be completed. Access official forms and instructions on the <a href="https://www.osha.gov/recordkeeping/forms" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">OSHA Recordkeeping Forms website</a>. </div><div><br></div><div><strong>4. Recordkeeping Period:</strong> OSHA records are maintained for each calendar year. Records must be maintained for at least five years beyond the covered calendar year, as mandated by <a href="https://www.osha.gov/laws-regs/regulations/standardnumber/1904/1904.33" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">OSHA retention and updating</a>. </div><div><br></div><div><strong>5. Electronic Reporting:</strong> Certain establishments have previously been required to electronically submit Form 300A annually through the <a href="https://www.osha.gov/injuryreporting/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">OSHA Injury Tracking Application (ITA)</a>, <em>however this Rule will change effective January 1, 2024, to include additional records that must be electronically submitted.</em> We will cover these updates in the second part of this series.  </div><div><br></div><div><strong>6. Privacy Concerns:</strong> Safeguarding individual privacy is important, particularly for logs that can be requested by other employees or OSHA. Employers should review OSHA’s guidance on <a href="https://www.osha.gov/recordkeeping/faq-search?combine=privacy" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Privacy Cases</a> for any needlestick injuries or other injury or illness that the employee desires to keep private. </div><div><br></div><div style="text-decoration:underline;"><strong>Insights for Effective OSHA Recordkeeping</strong> </div><div><br></div><div>Complying with OSHA recordkeeping requirements is not only a regulatory obligation but a strategic approach to maintaining a safe and healthy work environment. This section reviews specific insights tailored to the nuances of OSHA recordkeeping in long term care settings. </div><div><br></div><div><ol><li><strong>Identifying Risks:</strong> Long term care communities must understand specific risks inherent in health care work, such as musculoskeletal injuries, infectious disease exposures, and incidents related to resident falls. Precise identification enhances the accuracy of recorded incidents and will help the employer identify trends with employee injuries. <br><br></li><li><strong>Work-Relatedness Protocols:</strong> Establish clear and tailored protocols for determining the work-relatedness of injuries or illnesses. Given the difficulties of healthcare settings, particularly when identifying illness that are work-related or not, a standardized procedure should be designed to effectively determine causation and recordability.  <br><br></li><li><strong>Sharps Injuries Reporting and Analysis:</strong> Given the prevalence of sharps in healthcare settings, recording and analyzing incidents of sharps injuries should be recorded on both your OSHA 300 log and a separate “Sharps” or “Needlestick” log. Long term care communities should document the circumstances, types of sharps involved, and any follow-up actions taken to prevent future occurrences. <br><br></li><li><strong>Documenting Workplace Violence:</strong> OSHA requires documentation of work-related injuries resulting from acts of violence, including injuries caused by resident-on-staff behaviors. Long term care communities need comprehensive records to not only comply with regulations but also to address and prevent future incidents effectively. <br><br></li><li><strong>Temporary Workers Coordination: </strong>Collaboration with staffing agencies is common in long term care. Clear communication and coordination mechanisms for OSHA recordkeeping responsibilities ensure that incidents involving temporary workers are accurately documented and reported by either the staffing agency or the long term care community. <br><br></li><li><strong>Privacy-Compliant Recordkeeping:</strong> Due to the sensitive nature of healthcare information, long term care communities should prioritize privacy in recordkeeping. This involves not only documenting incidents but also safeguarding personal or confidential information in adherence to privacy regulations. <br><br></li><li><strong>Regularly Updated Procedures:</strong> OSHA regulations and recordkeeping requirements may evolve. Long term care communities should regularly review and update their recordkeeping procedures to align with the latest standards and ensure ongoing compliance. <br><br></li><li><strong>Recordkeeping for Continuous Improvement:</strong> OSHA recordkeeping isn't just about compliance; it's a tool for continuous improvement. Long term care communities can leverage records to analyze trends in injuries and illnesses, implementing targeted measures to address root causes and proactively enhance workplace safety. </li></ol></div><div><br></div><div style="text-decoration:underline;"><strong>Conclusion</strong></div><div><br></div><div>In this first installment of our two-part series on OSHA Recordkeeping within long term care, we've explored the most basic aspects of the OSHA Standard under 29 CFR Part 1904, but specific cases and situations can be more complicated and will likely require review of the additional information in the links above. Employers in long term care settings must understand that the OSHA recordkeeping is not only required but can be easily mismanaged if OSHA requirements are not appropriately followed and implemented. As we look ahead, our next article will navigate the landscape of new electronic submission regulations set to become effective on January 1, 2024.  <br></div><p>​</p>Within long term care, where meticulous recording and documentation are routine practices, the analysis of both resident and employee events takes a central role.
The OSHA Inspection Process: Types, Procedures, and Outcomeshttps://www.ahcancal.org/News-and-Communications/Blog/Pages/The-OSHA-Inspection-Process-Types,-Procedures,-and-Outcomes.aspxThe OSHA Inspection Process: Types, Procedures, and Outcomes11/20/2023 5:00:00 AM<p>​<span style="font-size:11pt;">In this article, we will expand on the <a href="/News-and-Communications/Blog/Pages/OSHA-Inspections-and-the-Bloodborne-Pathogens-Standard-in-LTC-Communities-.aspx" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">previous discussion</a> regarding the types of Occupational Safety and Health Administration (OSHA) inspections. Additionally, we will include OSHA procedures to expect and general outcomes of an inspection in a Long Term Care organization. </span></p><div><span style="font-size:11pt;">OSHA inspections can arise from various circumstances, including programmed assessments targeting high-hazard workplaces and unprogrammed responses to imminent dangers, fatalities, or employee complaints. The U.S. Bureau of Labor Statistics (BLS) has identified Healthcare and Social Assistance employers (including skilled nursing facilities and assisted living communities) as having high injury/illness rates, therefore being a target of and OSHA inspection is a high possibility.  <br></span><br><a href="https://www.bls.gov/charts/injuries-and-illnesses/number-and-rate-of-nonfatal-work-illnesses-by-industry.htm" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank" style="text-align:center;font-size:11pt;">Number and rate of nonfatal work illnesses in private industries (bls.gov) </a></div><div style="text-align:center;"><a href="https://www.bls.gov/charts/injuries-and-illnesses/number-and-rate-of-nonfatal-work-illnesses-by-industry.htm" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank"><br><img src="/News-and-Communications/Blog/PublishingImages/Pages/The-OSHA-Inspection-Process-Types,-Procedures,-and-Outcomes/Picture1.jpg" alt="Picture1.jpg" class="ms-rtePosition-4" style="margin:5px;" /></a></div><div><br></div><div><br><span style="font-size:11pt;">The on-site inspection procedures typically include a comprehensive examination of the facility's safety protocols, focusing on aspects such as infection control, general hazards, and employee training. OSHA compliance officers thoroughly assess areas like recordkeeping, physical hazards, personal protective equipment usage, and emergency response plans. The outcomes of these inspections may result in corrective measures, citations, or, ideally, acknowledgment of a well-maintained and secure environment for the facility employees. </span><br></div><div><br></div><div><strong class="ms-rteFontSize-3">Types of Inspections: </strong></div><div><br><div><ol><li><strong>Programmed Inspection</strong><strong>s:</strong><br><br></li><ul><li><span style="font-size:11pt;"><span style="color:#555555;font-size:14.6667px;background-color:#ffffff;">​​​Site-Specific Targeting (SST): OSHA uses a randomized system to target high-hazard workplaces based on their injury and illness rates. This system helps OSHA focus on industries and workplaces with higher risks.<br></span><br></span></li><li><span style="font-size:11pt;">E</span><span style="font-size:11pt;">mphasi</span><span style="font-size:11pt;">s</span><span style="font-size:11pt;"> programs: O</span><span style="font-size:11pt;">SHA publishes national, regional, and area emphasis programs identifying industries and specific hazards with historically high injury and illness rates for programmed inspections. Like SST inspections, emphasis program inspections are selected at random from an industry or hazard-specific list. LTC organizations (nursing facilities and assisted living communities) are considered high-hazard industries and have been the subject of several emphasis programs, including, most recently, OSHA’s COVID National Emphasis Program. <br><br></span></li><li><span style="font-size:11pt;">​</span><span style="font-size:11pt;">OSHA performs Federal and State inspections routinely. Inspection results for the long term care industry can be found on the <a href="https://www.osha.gov/ords/imis/industry.search?p_logger=1&sic=&naics=623110&State=All&officetype=All&Office=All&endmonth=11&endday=17&endyear=2018&startmonth=11&startday=17&startyear=2023&owner=&scope=&FedAgnCode=" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">OSHA inspection website​</a>. </span><span style="font-size:11pt;white-space:pre;"> </span><br> </li></ul><li><strong>Unprogrammed Inspections: </strong><div style="font-size:11pt;"></div></li></ol><div style="font-size:11pt;display:inline !important;"><blockquote style="margin-bottom:0px;margin-left:40px;border:none;padding-right:0px;padding-left:0px;"><div style="font-size:11pt;"><ul><li>​​Imminent Danger: OSHA responds immediately to reports of conditions or practices that pose an imminent danger to workers. This type of inspection is given the highest priority. <br><br></li><li><span style="font-size:11pt;">Fatalities and Catastrophes: OSHA investigates incidents resulting in fatality or the hospitalization of an employee due to a work-related event. <br></span><br></li><li><span style="font-size:11pt;">Complaints: OSHA often conducts inspections in response to complaints filed by workers or their representatives regarding unsafe or unhealthy working conditions. <br></span><br></li><li><span style="font-size:11pt;">Referrals: Inspections may be initiated based on referrals from other agencies, individuals, or organizations. <br></span><br></li><li><span style="font-size:11pt;">Follow-Up: OSHA may conduct follow-up inspections to ensure that previously cited violations have been corrected. ​</span></li></ul></div></blockquote></div></div><br></div><div><strong class="ms-rteFontSize-3">OSHA Inspection Procedures (On-Site):</strong><span class="ms-rteFontSize-3"> </span><br></div><div><br></div><div><ol><li><strong>Opening Conference:<br><br></strong></li><ul><li><strong style="font-size:11pt;">​</strong>The OSHA compliance officer explains the purpose of the inspection, the scope of the investigation, and the standards that apply. <br><br></li><li>The employer and employee representatives are invited to participate in the opening conference. <br>​</li></ul><li><strong style="font-size:11pt;">​​​​​</strong><strong style="font-size:11pt;">Presentation of Credentials: <br><br></strong></li><ul><li><span style="font-size:11pt;">​The OSHA compliance officer presents their credentials to confirm their identity. <br><br></span></li></ul><li><span style="font-size:11pt;"><strong>Walkaround Inspection: <br></strong></span><br></li><ul><li><strong style="font-size:11pt;">​</strong>The compliance officer, accompanied by the employer and employee representatives, conducts a walkthrough of the workplace. <br><br></li><li>They inspect for hazards, potential violations, and assess the overall safety of the workplace. <br><br></li></ul><li><span style="font-size:11pt;"><strong>Employee Interviews: <br></strong></span><br></li><ul><li><span style="font-size:11pt;">​The compliance officer may interview employees privately to inquire about workplace conditions, safety practices, and potential concerns. <br><br></span></li></ul><li><span style="font-size:11pt;"><strong>Document Review: <br><br></strong></span></li><ul><li><span style="font-size:11pt;">​​The officer reviews relevant records, such as injury and illness logs, training records, and safety procedures. <br></span><strong style="font-size:11pt;">​</strong></li></ul><li><strong style="font-size:11pt;">Closing Conference:<br><br></strong></li><ul><li><strong style="font-size:11pt;">​​</strong>After the inspection, the compliance officer holds a closing conference with the employer and employee representatives.<br><br></li><li>Findings, including any violations, are discussed, and the employer is informed of their rights and responsibilities. </li></ul></ol></div><div><br></div><div>Note that the specific procedures may vary based on the type of inspection (programmed or unprogrammed) and the circumstances leading to the inspection.  </div><div><br></div><div><strong class="ms-rteFontSize-3">OSHA Inspection Outcomes:</strong><span class="ms-rteFontSize-3"> </span></div><div><ol><br><li><strong>Citations and Penalties: <br><br></strong></li><ul><li><span style="font-size:11pt;">​If violations are found, OSHA may issue citations detailing the specific standards violated and propose penalties. The severity of the violation, good faith of the employer, the employer’s size, and the employer's history of compliance influence the penalties. <br><br></span></li></ul><li><strong style="font-size:11pt;">Abatement Period: <br><br></strong></li><ul><li><strong style="font-size:11pt;">​</strong>The employer is given a specific period, known as the abatement period, to correct the identified violations. The length of this period depends on the severity of the violation. <div><br></div></li></ul><li><strong style="font-size:11pt;">Informal Conference: <br></strong><br></li><ul><li><span style="font-size:11pt;">​Employers have the option to request an informal conference with OSHA to discuss the inspection results, proposed penalties, and abatement measures. This provides an opportunity for clarification and negotiation. <br><br></span></li></ul><li><strong style="font-size:11pt;">Contesting Citations: <br></strong><br></li><ul><li><span style="font-size:11pt;">​Employers have the right to contest OSHA citations and penalties. This involves filing a Notice of Contest within 15 business days of receiving the citations. Even if the employer participates in an informal conference, this deadline remains and cannot be changed by OSHA. <br><br></span></li></ul><li><strong style="font-size:11pt;">Abatement Verification: <br></strong><br></li><ul><li><span style="font-size:11pt;">​After correcting the cited violations, the employer may be required to provide documentation to OSHA as proof of abatement. This ensures that corrective actions have been taken. <br><br></span></li></ul><li><strong style="font-size:11pt;">Follow-Up Inspections: <br><br></strong></li><ul><li><span style="font-size:11pt;">​In some cases, OSHA may conduct follow-up inspections to verify that the identified hazards have been properly addressed and corrected. <br><br></span></li></ul><li><strong style="font-size:11pt;"></strong><strong style="font-size:11pt;">Employee Notification: <br><br></strong></li><ul><li><span style="font-size:11pt;">​Employers are generally required to post a copy of the citations at or near the location of the violation for three days or until the violation is abated, whichever is longer. This is to inform employees of the inspection results. <br><br></span></li></ul><li><strong style="font-size:11pt;">Training and Improvements: <br></strong><br></li><ul><li><span style="font-size:11pt;">​OSHA may recommend or require additional employee training or improvements in safety procedures to prevent future violations. These additional steps are typically referred to as “enhanced abatement” and may be used when negotiating a reduced citation. ​</span></li></ul></ol></div><div><br></div><div>It's important for employers to address OSHA inspection findings promptly, take corrective actions, and maintain open communication with OSHA throughout the process. Proactive measures to ensure ongoing compliance with safety regulations well before OSHA begins an inspection can help prevent future issues and promote a safer work environment. <br></div><p>​</p>In this article, we will expand on the previous discussion regarding the types of Occupational Safety and Health Administration inspections.
OSHA Enforcement: A Guide to Federal OSHA and State OSH Programshttps://www.ahcancal.org/News-and-Communications/Blog/Pages/OSHA-Enforcement-A-Guide-to-Federal-OSHA-and-State-OSH-Programs.aspxOSHA Enforcement: A Guide to Federal OSHA and State OSH Programs11/13/2023 5:00:00 AM<p></p><div>United States law requires worker safety to be enforced either through an approved state-level occupational safety and health (OSH) program or the federal Occupational Safety and Health Administration (OSHA). In other words, each workplace is regulated by either Federal OSHA or a state OSH program. Whether your facility is covered by a federal or state program depends on your state. If your state has an approved program, you will respond to your state-level OSH agency, rather than Federal OSHA.  </div><div><br></div><div>Some states choose to develop state-level OSH programs because they can tailor workplace safety regulations to the specific needs of their states – as long as they meet or exceed the minimum requirements set by Federal OSHA. </div><div><br></div><div>There are <strong>currently 22 State Plans</strong> covering both <span style="text-decoration:underline;">private sector</span> and public employees, including:  </div><div><div><ul><li>Alaska </li><li><span style="font-size:11pt;">Arizona </span></li><li><span style="font-size:11pt;">California </span></li><li><span style="font-size:11pt;">Hawaii </span></li><li><span style="font-size:11pt;">Indiana </span></li><li><span style="font-size:11pt;">Iowa </span></li><li><span style="font-size:11pt;">Kentucky </span></li><li><span style="font-size:11pt;">Maryland </span></li><li><span style="font-size:11pt;">Michigan </span></li><li><span style="font-size:11pt;">Minnesota </span></li><li><span style="font-size:11pt;">Nevada </span></li><li><span style="font-size:11pt;">New Mexico </span><span style="font-size:11pt;">​</span></li><li><span style="font-size:11pt;">North Carolina </span></li><li><span style="font-size:11pt;">Oregon </span></li><li><span style="font-size:11pt;">Puerto Rico </span></li><li><span style="font-size:11pt;">South Carolina </span></li><li><span style="font-size:11pt;">Tennessee </span></li><li><span style="font-size:11pt;">Utah </span></li><li><span style="font-size:11pt;">Vermont </span></li><li><span style="font-size:11pt;">Virginia </span></li><li><span style="font-size:11pt;">Washington </span></li><li><span style="font-size:11pt;">Wyoming </span></li></ul></div><div><span style="font-size:11pt;"><br></span></div>There are <strong>seven additional state plans</strong> covering <span style="text-decoration:underline;">only public employees</span>. This means privately owned facilities would still only follow federal requirements – including:</div><div><div><ul><li>Connecticut <br></li><li><span style="font-size:11pt;">Illinois </span></li><li><span style="font-size:11pt;">Maine </span></li><li><span style="font-size:11pt;">Massachusetts </span></li><li><span style="font-size:11pt;">New Jersey </span></li><li><span style="font-size:11pt;">New York </span></li><li><span style="font-size:11pt;">Virgin Islands  </span></li></ul></div><div><span style="font-size:11pt;"> </span><br></div><div>A map of all OSHA Approved State Plans is available <a href="https://www.osha.gov/stateplans" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">here</a>, and specific State Plans are available <a href="https://www.osha.gov/stateplans/statestandards" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">here</a>.  </div><div><br></div><div><span style="font-size:11pt;">Even for LTC communities covered by a state plan, it is generally helpful to view the Federal OSHA standards to understand the baseline requirement they must meet. From there, providers can evaluate any additional state requirements that should be met. </span></div><div><br></div><div>Several state OSH programs have established their own regulations or guidelines related to Bloodborne Pathogens, Workplace Violence, and Infectious Diseases. Below are links to state programs with specific standards applicable to health care. </div><div><br></div></div><a href="https://labor.alaska.gov/lss/oshhome.htm" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><div><strong style="text-decoration:underline;">Alaska</strong><span style="font-size:11pt;color:#555555;">: Alaska has additional healthcare requirements related to bloodborne pathogens and needle stick injury protections.  </span></div></div></blockquote></a><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><div><br></div></div><div><div><a href="https://www.dir.ca.gov/dosh/" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank" style="text-decoration:underline;"><strong>California</strong></a>: California's Cal/OSHA has a comprehensive Aerosol Transmissible Diseases (ATD) standard that addresses the protection of workers in healthcare settings where there is a risk of exposure to airborne infectious agents. California also has regulations related to Workplace Violence Prevention in healthcare settings, requiring employers to develop and implement violence prevention plans. </div></div><div><div><br></div></div><a href="https://dllr.state.md.us/labor/mosh/" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank"><div><div><strong style="text-decoration:underline;">Maryland</strong><span style="font-size:11pt;color:#555555;">: Maryland's OSH program has developed guidance on preventing workplace violence in health care settings. </span></div></div></a><div><div><br></div></div><div><div><a href="https://www.michigan.gov/leo/bureaus-agencies/miosha" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank" style="text-decoration:underline;"><strong>Michigan</strong></a>: Michigan OSHA has a unique Bloodborne Infectious Diseases standard that applies to healthcare facilities. </div></div><div><div><br></div></div><div><div><a href="https://www.dli.mn.gov/about-department/our-areas-service/minnesota-osha-compliance" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank" style="text-decoration:underline;"><strong>Minnesota</strong></a>: Minnesota OSHA has guidelines for preventing workplace violence in healthcare and social service settings. Minnesota also has additional training requirements for infectious agents that are likely to occur in the individual workplace. </div></div><div><div><br></div></div><div><div><a href="https://dir.nv.gov/OSHA/Home/" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank" style="text-decoration:underline;"><strong>Nevada</strong></a>: Nevada has workplace violence requirements specifically for medical facilities. </div></div><div><div><br></div></div><div><div><a href="https://www.nj.gov/health/workplacehealthandsafety/peosh/" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank" style="text-decoration:underline;"><strong>New Jersey</strong></a>: New Jersey has its own Infectious Disease Standard that applies to healthcare facilities and addresses measures to protect workers from exposure to infectious diseases. Note that this standard only applies to facilities owned by state or local governments. </div></div><div><div><br></div></div><div><div><a href="https://osha.oregon.gov/Pages/index.aspx" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank" style="text-decoration:underline;"><strong>Oregon</strong></a>: Oregon OSHA has provided guidelines for employers on addressing workplace violence hazards, including a focus on the healthcare industry. Oregon OSHA also has additional rules for Bloodborne Pathogens and SHARPS Injury logs. </div></div><div><div><br></div></div><div><div><a href="https://www.trabajo.pr.gov/" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank" style="text-decoration:underline;"><strong>Puerto Rico</strong></a>: PR OSHA has enacted a standard to address workplace violence situations, including procedures for handling domestic violence incidents in the workplace. </div></div><div><div><br></div></div><div><div><a href="https://www.tn.gov/workforce/employees/safety-health/tosha.html" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank" style="text-decoration:underline;"><strong>Tennessee</strong></a>: Tennessee OSHA has additional requirements related to Bloodborne Pathogens and Sharps Injury Prevention. </div></div><div><div><br></div></div><div><div><a href="https://www.lni.wa.gov/safety-health/" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank" style="text-decoration:underline;"><strong>Washington</strong></a>: Washington state's Department of Labor and Industries (L&I) has specific regulations concerning Workplace Violence Prevention in health care settings. There are also unique State requirements for Bloodborne Pathogens and Airborne Contaminants including biological agents, such as viruses. <br></div></div></blockquote><div><div><br></div><div>In conclusion, as you are implementing your employee safety and health programs, you should know whether your facility is regulated by Federal OSHA or a state-run OSH agency. Based on that, you will be able to determine what, if any, additional requirements apply to you and your company.   <br></div><br></div><p>​</p>United States law requires worker safety to be enforced either through an approved state-level occupational safety and health program or the federal Occupational Safety and Health Administration.
OSHA Inspections and the Bloodborne Pathogens Standard in LTC Communitieshttps://www.ahcancal.org/News-and-Communications/Blog/Pages/OSHA-Inspections-and-the-Bloodborne-Pathogens-Standard-in-LTC-Communities-.aspxOSHA Inspections and the Bloodborne Pathogens Standard in LTC Communities10/31/2023 4:00:00 AM<p></p><div>In this article, we will discuss reasons why OSHA may inspect a long term care (LTC) center. We also will cover some highlights of the OSHA Bloodborne Pathogens Standard and its application in LTC facilities/communities.  </div><div><br></div><div><strong>Reasons for an OSHA Inspection</strong> </div><div><span style="font-size:11pt;">The purpose of an OSHA inspection is to ensure compliance with safety standards and protect the well-being of both employees and residents. The top fi</span><span style="font-size:11pt;">ve most common reasons an inspection may be conducted in an LTC center include:  </span><br></div><div><br></div><div><ol><li><strong>Complaints</strong>: OSHA may conduct inspections in response to complaints filed by employees, residents, or their families.  <br></li><li><span style="font-size:11pt;"><strong>Incident Investigations</strong>: OSHA may investigate the facility/community following a workplace incident, particularly if it resulted in serious injury, illness, or death.  </span></li><li><span style="font-size:11pt;"><strong>Random Inspections</strong>: While less common, OSHA may conduct random inspections under an emphasis program to ensure health care communities are complying with safety standards.  </span></li><li><span style="font-size:11pt;"><strong>Follow-up Inspections</strong>: If a center has been previously cited for OSHA violations, especially serious violations, OSHA may conduct follow-up inspections to ensure that corrective actions have been taken to address the identified hazards.  </span></li><li><span style="font-size:11pt;"><strong>Media Referrals</strong>: If OSHA learns of a potential safety violation through the media—TV broadcasts, newspaper, internet articles—OSHA may conduct targeted inspections focusing on the hazard or event shown in the media report. </span></li></ol></div><div><br></div><div><strong>OSHA’s Bloodborne Pathogen Standard </strong></div><div><span style="font-size:11pt;">Once an inspection is opened in a health care center, OSHA frequently looks for viol</span><span style="font-size:11pt;">ations of the </span><em style="font-size:11pt;">Bloodborne Pathogens Standard</em><span style="font-size:11pt;"> (</span><a href="https://www.osha.gov/bloodborne-pathogens/standards" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank" style="font-size:11pt;">Bloodborne Pathogens - Standards | Occupational Safety and Health Administration (osha.gov</a><span style="font-size:11pt;">). This standard protects against potential Blood or Other Potentially Infectious Materials (OPIM) health hazards, especially in LTC centers caring for vulnerable populations. </span><br></div><div><br></div><div><strong>Implementing an OSHA Bloodborne Pathogen Program </strong></div><div><span style="font-size:11pt;">Implementing an effective OSHA Bloodborne Pathogen Program in your LTC facility will include the following:</span><br></div><div><br></div><div><span style="font-size:11pt;"><strong>Establish a written Exposure Control Plan (ECP): </strong></span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">An Exposure </span><span style="font-size:11pt;">Control Plan is a comprehensive document developed by employers to minimize or eliminate occupational exposure to bloodborne pathogens in the workplace. It is the primary requirement of OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030) and is particularly important where employees may come into contact with blood or other potentially infectious materials. The Exposure Control Plan outlines the employer's strategy for protecting employees from exposure to bloodborne pathogens, including HIV, Hepatitis B, and Hepatitis C. </span></div></blockquote><div><br></div><div><span style="font-size:11pt;"><strong>Review and Update the Plan </strong></span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">This segment outlines the plan's periodic assessment, typically conducted annually or more frequently if required. It designates a responsi</span><span style="font-size:11pt;">ble individual or team for the review process. During this evaluation, the effectiveness of existing safety measures is analyzed, considering feedback from employees and any changes in regulations. Documentation of the review process, including modifications made to the plan, is recommended for compliance. Once updates are implemented, staff members should be trained on any changes.  </span></div></blockquote><div><br></div><div><strong style="font-size:11pt;">Universal Precautions </strong></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">Universal Precautions involve treating all human blood, certain body fluids, and other potentially infectious materials as if they are infectious for HIV, HBV, HCV, and other bloodborne pathogens, regardless of the perceived risk. Universal Precautions must be observed by all employees when dealing with blood or potentially infectious materials. This includes using appropriate personal protective equipment (PPE) such as gloves, masks, and eye protection. </span></div></blockquote><div><br></div><div><span style="font-size:11pt;"><strong>Standard Precautions</strong></span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">Standard Precautions expand on Universal Precautions and assume that every patient is potentially infectious. Standard Precautions integrate infection control practices used to prevent the transmission of diseases in healthcare settings when providing care to all patients, regardless of their diagnosis or presumed infection status.  </span></div></blockquote><div><br></div><div><span style="font-size:11pt;"><strong>Engineering controls </strong></span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">Engineering controls involve physical changes to the building or equipment and create a safer work environment by physically removing or isolating hazards. For instance, sharps disposal containers are puncture-resistant containers designed to safely dispose of needles and other sharp medical instruments, minimizing the risk of accidental needlesticks among healthcare workers. Other examples of engineering controls include self-sheathing needles, safer medical devices that reduce the risk of needlesticks, and biohazardous waste disposal systems. These controls are specifically designed to prevent or minimize contact with blood or other potentially infectious materials. </span></div></blockquote><div><br></div><div><span style="font-size:11pt;"><strong>Work practice controls  </strong></span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">Work practice controls refer to specific behaviors and practices designed to minimize the risk of occupational exposure to bloodborne pathogens. Unlike engineering controls (physical devices) and personal protective equipment (PPE), work practice controls focus on safe work habits and procedures. Examples include Hand Hygiene, Proper Sharps Handling, Labeling Systems, Emergency Procedures, Cleaning and Disinfection, and Training.  </span></div></blockquote><div><br></div><div><span style="font-size:11pt;"><strong>Personal Protective Equipment (PPE)  </strong></span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">PPE, including gloves, masks, face shields, gowns, and eye protection, acts as a barrier between employees and potentially infectious materials. Its purpose is to prevent direct contact with blood or other body fluids, minimizing the risk of exposure to bloodborne pathogens. Exposure Control Plan outlines the specific types of PPE required for various tasks and exposure risks. PPE considerations include Device Selection, Use, Training, Availability, Maintenance and Replacement, and Disposal.  </span></div></blockquote><div><br></div><div><span style="font-size:11pt;"><strong>Hepatitis B vaccinations  </strong> </span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">Ensuring compliance with Hepatitis B vaccination requirements protects employees from the potentially severe consequences of HBV infection. It also demonstrates the employer's commitment to providing a safe and healthy work environment, in accordance with OSHA regulations. Key components of the Hepatitis Vaccination Requirement include Offer of Vaccination, Voluntary Employee Decision, Informed Decision, Vaccination Schedule, and Documentation. </span></div></blockquote><div><br></div><div><span style="font-size:11pt;"><strong>Post-exposure evaluation and follow-up </strong></span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">When an employee experiences an exposure, the employer should respond, including Immediate Care, Reporting, Medical Evaluation, Post-Exposure Prophylaxis (PEP), Follow-Up Care, and Documentation.  </span></div></blockquote><div><br></div><div><span style="font-size:11pt;"><strong>Training </strong> </span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">Training must cover the specifics of the Exposure Control Plan, including details about bloodborne pathogens, modes of transmission, the center's exposure control procedures, proper use of personal protective equipment (PPE), safe work practices, and emergency response protocols. Initial training is provided to employees at the time of their initial assignment to tasks where occupational exposure may occur. Annual training is also required to ensure that employees stay updated on best practices and any changes in procedures or regulations.  </span></div></blockquote><div><br></div><div><span style="font-size:11pt;"><strong>Recordkeeping </strong></span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">The center should keep the following documents: Training Records, Hepatitis B Vaccination Records, Post-Exposure Incident Records, Written Exposure Determination Records, and Sharps Injury Logs.  </span></div></blockquote><div><br></div><div><span style="font-size:11pt;"><strong>Overlap with Existing Infection Control Plans</strong> </span></div><div><span style="font-size:11pt;">The good news is that most LTC centers will already have infection control and prevention plans in place that likely cover most of the OSHA Exposure Control Plan requirements. Careful attention should be paid, however, to Hepatitis B vaccination requirements and Sharps Log recordkeeping, which might not be covered by your existing Plan.  </span><br></div><div><br></div><div><span style="font-size:11pt;"><strong>Conclusion </strong></span></div><div><span style="font-size:11pt;">In the scope of LTC, where compassion and medical expertise converge, the OSHA Bloodborne Pathogens Standard stands as a safeguard, protecting both those in care and those providing it. By embracing technology and fostering a culture of safety, LTC centers can navigate the complexities of the Bloodborne Pathogens Standard effectively, ensuring the safety and well-being of everyone involved. </span><br></div><div><br></div><div><span style="font-size:11pt;"><strong>Additional Resources: </strong></span></div><ul><li><span style="font-size:11pt;"><a href="https://www.osha.gov/bloodborne-pathogens/quick-reference" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">Bloodborne Pathogens and Needlestick Prevention - Quick Reference Guide </a></span></li><li><span style="font-size:11pt;"><a href="https://www.osha.gov/sites/default/files/publications/bbfact05.pdf" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">OSHA Factsheet Hepatitis B Vaccination Protection </a>  </span></li></ul><p>​<br></p>In this article, we will discuss reasons why OSHA may inspect a long term care center.