Assisted Living, Home Health, Skilled Nursing Facility

Risk and rising fines increase the importance of OSHA

Review your agency’s policies for keeping employees safe from hazards. The majority of employers are subject to the Occupational Safety and Health Act, and more workers are injured in the health care and social assistance industry sector than any other, according to the Occupational Safety and Health Administration (OSHA).

The law mandates that employers provide a workplace free from known health and safety hazards and to comply with applicable OSHA standards.

In addition, 28 jurisdictions operate OSHA-approved statewide programs that are at least as stringent as OSHA’s but may include additional requirements for employers in those locations.

Some requirements, such as keeping employees safe from workplace violence and having emergency exit routes pertain to all employers. Employers also need to display in a conspicuous place either OSHA’s or a state program’s official poster alerting employees to their rights. There are also recordkeeping requirements.

Take note of provider-specific standards

Some standards are particular to the health care industry. Some of the requirements include taking safeguards to prevent or limit exposure to unsafe chemicals or situations, having procedures to deal with an incident and employee training.

Penalties for noncompliance skyrocket

Many OSHA investigations into safety concerns stem from complaints filed by employees, says attorney Carla Gunnin with Jackson Lewis in Atlanta. OSHA has been active in inspecting and issuing citations to medical providers, she says.

Moreover, the penalties for OSHA violations have jumped substantially. Previously penalties ranged from $7,000 to $70,000 per violation; it’s now $12,471 to $124,709 per violation. Penalties for failing to abate violations have increased from $7,000 per day to $12,471 per day.

Employers also can be ordered to cease and desist an activity or rectify a hazardous situation, says attorney Steven Swirsky with Epstein Becker & Green in New York. Being found in violation of OSHA also generates significant negative publicity, he adds.

OSHA’s website provides tools and resources to help employers comply, including model programs for some standards and e-tools.

Start with an assessment

The first step to OSHA compliance is determining what standards your agency must meet and where it falls short. Start with a mock audit, Gunnin suggests.

Agencies may use one or more methods to conduct the initial assessment.

Conduct a self-assessment.

  • OSHA offers a self-assessment checklist that employers can use to see whether their compliance has gaps.

Obtain free help from OSHA.

  • Small and medium-sized employers can contact OSHA’s free and confidential onsite consultation program. The program helps identify hazards, provides advice on compliance with OSHA standards and helps establish injury and illness prevention programs.
  • The program is not part of OSHA’s enforcement arm and using it will not result in penalties or citations, according to OSHA.
Get help from an affiliate. Home care agencies connected to a larger organization — such as a health system — may be able to get assessment assistance from that entity, Gunnin says. — Marla Durben Hirsch (