This guest column was written by M3 Insurance, an Elite Premier Business Partner of WHCA/WiCAL. Guest columns are written by WHCA/WiCAL’s Elite Premier, Elite, Prime, and Select Business Partners. If you are interested in writing a guest column, please contact Jena Jackson for more information.

The U.S. Department of Labor announced its effort for short-term “highly focused inspections” and enforcement in hospitals and nursing care facilities while they work to finalize a permanent healthcare standard. These inspections will be focused on protections for workers against COVID-19 hazards, and will be taking place from March 9th through June 9th of 2022.

Note: Follow-up onsite inspections will be conducted at facilities that were previously issued citations, as well as where complaints were received but OSHA did not conduct in-person inspections.

NAICS Codes Under Focused Inspection Effort:

622110 General Medical and Surgical Hospitals
622210 Psychiatric and Substance Abuse Hospitals
623110 Nursing Care Facilities (Skilled Nursing Facilities)
623312 Assisted Living Facilities for the Elderly

It is recommended that providers who fall into this category promptly review and assess the following for their organizations, as these are the areas Compliance Officers will be focused on during inspections:

• Previously cited COVID-19-related violations have been corrected or are in the process of being corrected, and the correction remains in place. Any COVID-19-related complaint items have been corrected.
• A COVID-19 plan remains in place that includes preparedness, response, and control measures regarding COVID-19.
• Control measures are in place and are effective, including procedures for determining vaccination status. OSHA states that “verification of vaccination protocols may be an indicator of a facility’s overall COVID-19 mitigation strategies,” and that they will refer any vaccination-related deficiencies to the Centers for Medicare and Medicaid Services (CMS). While assisted living entities are not required to comply with the CMS vaccination mandate, it is recommended to have a system in place to track employee vaccination rates and to encourage vaccination.
• Log of all employee COVID-19 positive cases (work-related and non-work-related), the OSHA 300 Log and OSHA 300A Summary for calendar years 2020, 2021, and 2022. It is recommended to have documentation of the facility’s assessment in determining whether a positive employee case was work-related or not.
• Procedures for conducting hazard assessments and protocols for personal protective equipment (PPE) use. Compliance Officers may review documentation of any procedures or efforts made by the employer to obtain and provide appropriate and adequate supplies of PPE. They will look to ensure employees and visitors are required to use face coverings or facemasks in accordance with CDC guidance.
• Respiratory Protection Program- written policy/procedure, medical evaluations, fit tests, employee training records, and proper use of respirators. Employees will likely be interviewed regarding their knowledge and compliance with this standard
• Procedure and documentation is in place for screening workers and/or any measures to facilitate physical distancing (e.g., barriers or administrative measures to encourage 6-foot distancing).

Why the continued focus on healthcare?

• Nursing assistants had the highest number of days away from work (DAFW) of all occupations
• DAFW cases for RNs increased by 290%
• Total injury/illness cases for healthcare and social services increased 40%, while cases in all other private industries remained the same or decreased

Source: 2020 BLS Statistics

During an inspection, Compliance Officers will also complete a limited walkaround of areas designated for COVID-19 patient treatment or handling (common areas, walkways, and vacant treatment areas where patients have been or will be treated), including performing employee interviews to determine compliance. The scope of an inspection may be expanded where plain-view hazards are identified during the walkaround, or where information obtained from workers indicate deficiencies in compliance.

While the OSHA Healthcare ETS has expired, OSHA will accept continued compliance with the Healthcare ETS as satisfying employers’ related obligations under the General Duty Clause, Personal Protective Equipment and Respiratory Protection standards.

A link to the full memorandum can be found here.

This enforcement notification applies currently to states covered by federal OSHA, and M3 will continue to monitor for adoption by OSHA-approved State Plans.

Quick Tips to mitigate risk when OSHA comes knocking

• Contact M3 immediately to guide you through the process
• Educate employees to bring the Compliance Officer to a conference room until whoever is designated to manage the inspection arrives
• Determine the scope of the inspection and limit inquires as applicable
• Do not allow the Compliance Officer free reign of the building, accompany
• Set ground rules and expectations with the Compliance Officer
• Prepare employees if Compliance Officer plans to conduct interviews
• Review COVID-19 protocols as listed above for compliance