The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) announced on October 14, 2021, that it had conducted a follow-up inspection of an Illinois nursing facility on July 28, 2021, and issued citations for one repeat and five serious health violations, with proposed penalties of $83,675. In June 2020, an employee died after exposure to coronavirus at the nursing facility.
The inspection was part of the National Emphasis Program for Coronavirus Disease 2019 and the Emergency Temporary Standard for Healthcare. During the inspection, OSHA did find that the Illinois nursing facility was requiring employees to wear N95 respirators while entering the quarantine area and providing care to suspected coronavirus positive residents. However, the facility failed to ensure proper use of respirators and to fit test all employees to ensure there was an effective seal, as required.
Additionally, OSHA determined that the facility failed to implement a hazard assessment process to evaluate for potential coronavirus exposure, track the vaccination status of employees, erect barrier and control procedures to maintain six feet of distancing between employees at entry points and nursing stations, and control access to the quarantine zone by staff and patients.
OSHA Area Director Jake Scott stated, “Simply wearing a respirator is not enough. Employers must ensure respirators fit correctly and maintain a face-to-facepiece seal to ensure they protect the user from the spread of infectious diseases. After more than a year of fighting this pandemic, employers should know the procedures to minimize workers’ risk of exposure and take every precaution.”
The Illinois facility has 15 business days from receipt of its citations and penalties to comply, request an informal conference with OSHA’s area director, or contest the findings before the Independent Occupational Safety and Health Review Commission.
OSHA’s National Emphasis Program for Coronavirus Disease 2019 requirements can be accessed at Revised National Emphasis Program – Coronavirus Disease 2019 (COVID-19) | Occupational Safety and Health Administration (osha.gov).
OSHA’s Emergency Temporary Standard for Healthcare requirements can be accessed at COVID-19 Healthcare ETS | Occupational Safety and Health Administration (osha.gov).
Issue:
Employers are obligated to comply with OSHA guidelines and standards, and to ensure that all healthcare staff work in a safe environment. Failure by a facility to follow OSHA guidelines and regulations may result in citations and financial and other penalties. Every employee who is required to wear a respirator while providing care or services must have a medical evaluation and a fit test completed to ensure proper fit of the respirator for the employee. Leaders of the facility must be knowledgeable of the requirements of medical evaluation and fit testing for respirators prior to assigning their use.
Discussion Points:
- Review your policy and procedures for the use of medical respirators in your facility. Ensure that a medical evaluation and fit testing for medical respirators are incorporated into your policies.
- Train staff, including those responsible for fit testing and medical evaluation completion, on your policy and procedures of the use of medical respirators. Document that these trainings occurred, and place each signed document in the employee’s individual education file.
- Periodically audit employee files for those who have been assigned to use medical respirators to determine that a medical evaluation was completed, and that fit testing was performed prior to the use of a medical respirator. Submit findings to the QAA/QAPI Committee for review, implementation of corrective actions, and monitoring if any irregularities are discovered.
