By Lillian Hartgrove, State Board of Education Chairman
Special to the UCBJ
On March 2, 2022, the U.S. Department of Labor Occupational Safety and Health Administration (OSHA) issued a Memorandum for a COVID-19 Focused Inspection Initiative in Healthcare. The Initiative is intended to supplement OSHA’s targeted enforcement under the COVID-19 national emphasis program and is directed at hospitals and skilled nursing care facilities that OSHA had previously inspected or investigated. In the Memorandum, OSHA notes that the intent is to “encourage employers in these industry sectors to take the necessary steps to protect their workers against the hazards of COVID-19.”
The partial-scope inspections called for in the Initiative are to be conducted at establishments covered by NAICS codes for (1) general medical and surgical hospitals; (2) psychiatric and substance abuse hospitals; (3) nursing care facility/skilled nursing facilities; and (4) assisted living facilities for the elderly.
Facilities within these codes listed above may be selected for inspections under the Initiative if they meet one of the following criteria:
- Follow-up inspection of any prior inspection where COVID-19 related citation or hazard alert letter was issued;
- Follow-up or monitoring inspections for randomly selected closed COVID-19 unprogrammed activity to include COVID-19 complaints and rapid response investigations; or
- Monitoring inspections for randomly selected, remote only COVID-19 inspections where COVID-19 related citations were previously issued.
The time period for the Initiative is to take place over a three-month period from March 9, 2022 to June 9, 2022.
The Memorandum provides procedures for inspectors and directs that the healthcare inspections should be limited to the following assessments:
- Determine whether previously cited COVID-19-related violations have been corrected or are still in the process of being corrected.
- Determine whether the employer has implemented a COVID-19 plan that includes preparedness, response, and control measures.
- Verify the existence and effectiveness of all control measures, including procedures for determining vaccination status by reviewing relevant records. OSHA will refer any vaccination-related deficiencies to the Centers for Medicare and Medicaid Services (CMS).
- Request and evaluate the establishment’s COVID-19 log, OSHA 300 Logs, OSHA 300A Summary, and any applicable OSHA 301 Incident Reports for calendar years 2020, 2021, and 2022 (if available) to identify work-related cases of COVID-19.
- Review the facility’s procedures for conducting hazard assessments and protocols for personal protective equipment (PPE) use.
- Conduct a limited records review of the employer’s respiratory protection program. The records reviewed may be limited to the written respiratory protection program and fit tests, medical evaluations, and training records for the interviewed employees.
- Perform a limited, focused 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 “walkaround” portion of the inspection is to be limited but may be expanded where the walkaround indicates deficiencies in such areas as (1) compliance with the Respiratory Protection Standard, fit testing, medical evaluations, training, and proper use of respirators; (2) implementing procedures for screening workers; (3) measures to facilitate physical distancing; (4) implementing procedures to obtain and provide appropriate supplies of PPE; and (5) the use of face coverings in accordance with the Centers for Disease Control and Prevention’s (CDC) guidance.
The Memorandum concludes by noting that where violations of OSHA standards, regulations, or the general duty clause are not observed or documented, (inspectors) should close the inspection and mark it as “in compliance.”
The OSHA Memorandum may be accessed at https://www.osha.gov/laws-regs/standardinterpretations/2022-03-02.