The Occupational Safety and Health Administration (OSHA) has announced a new National Emphasis Program (NEP) (pdf) that sets forth the policies and procedures for targeting and addressing occupational illnesses and injuries most commonly experienced in nursing and residential care facilities. As described in the NEP, these hazards include ergonomic stressors relating to resident handling; exposure to blood and other potentially infectious materials; exposure to tuberculosis; workplace violence; and slips, trips, and falls. The NEP discusses each of these areas and provides guidance to OSHA compliance staff on how best to conduct investigations to assess potential hazards. OSHA’s NEPs are designed to focus on specific hazards in a particular industry for a three-year period.

The impetus for this renewed focus on nursing and residential care facilities, according to OSHA, is findings by the Bureau of Labor Statistics (BLS) that the rate of employee injury and illness that results in days away from work, restricted work activity and job transfers (the “DART” rate) is particularly high in this industry. Specifically, the BLS found that in 2010, employees in nursing and residential care facilities lost work due to workplace injuries and illnesses at a rate that was 2.3 times higher than that experienced by employees in all private industries as a whole. Therefore, under the new NEP, OSHA will look closely at nursing and residential care facilities that have a DART rate of 10 or higher per 100 full-time workers.

The NEP’s executive summary explains that the program does not include any significant changes to the industry specific NEP OSHA conducted ten years ago, apart from the fact that the new NEP includes sections addressing workplace violence. In September 2011, OSHA issued a compliance directive – Enforcement Procedures for Investigating or Inspecting Incidents of Workplace Violence – that established uniform procedures for OSHA field officers when responding to incidents and complaints of workplace violence. The new NEP states that workplace violence “is a recognized hazard in nursing and residential care facilities.” Pursuant to the workplace violence directive, therefore, OSHA compliance officers who conduct programmed inspections at these facilities are instructed “to investigate for the potential or existence of this hazard.”

The current NEP addresses enforcement-related procedures only. The NEP stipulates that voluntary guidelines published by OSHA will not be used as a basis for citations issued under this NEP.

In a press release, David Michaels, assistant secretary of labor for occupational safety and health, said: “These are people who have dedicated their lives to caring for our loved ones when they are not well. It is not acceptable that they continue to get hurt at such high rates," adding, “Our new emphasis program for inspecting these facilities will strengthen protections for society's caretakers."

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