How Many Different Things Can OSHA Cite A Healthcare Facility For?

Did you know?  The FY 2024 budget request for OSHA is approximately $738.7 million, an increase of more than $106.3 million from FY 2023. The upcoming fiscal year begins Oct. 1.  Be prepared.

How many different things can OSHA (Occupational Safety and Health Administration) cite a Healthcare Facility for?  A few? Ten or more?  It’s a good question that gets asked daily in medical and dental offices across the United States.  Think of this scenario.  Your front desk employee comes back to your office on a Monday morning and says, “Mr. Johnson from OSHA is up front and wants to talk to you”.  Your heart sinks. 

Your mind races as to what to do next.  Should I alert my staff and get things cleaned up? Should I stall him and hope he goes away?  All bad options, but you know you are not up to par with OSHA regulations.  You haven’t conducted safety training since the days of the VHS Tape “If Saliva were Red” and haven’t updated your needles to engineered safety devices because you thought your supplier was just trying to get you to pay more.  You think to yourself, “What will he be looking for?  Maybe he’s just here on a routine visit.” 

OSHA inspections are broken down into three (3) parts; 1) An opening conference 2) A “walk around” and 3) A closing conference.  Unfortunately for you, Mr. Johnson is here based on a complaint from a former employee that you fired.  This disgruntled employee stated that they were subjected to an unsafe work environment, and that you, the employer, chose money over the safety and well-being of the employees. 

Serious charges.  The opening conference begins with a cordial introduction and then moves to outlining the complaints.  All you hear is Bloodborne Pathogens Standard, Hazard Communication Standard, Needle Stick Safety and Prevention Act.  The words meld together like clouds drifting in the sky.  “These are very serious allegations” says Mr. Johnson “We will need to conduct a thorough walk thru of your facility”. You nod your head with uneasy acceptance.  Let the inspection begin!

What are the top things that OSHA looks for in Medical and Dental Offices?  Here is a list of the top inspected categories (No particular order).

  • Hazard Communication
  • Bloodborne Pathogens
  • Ionizing Radiation
  • Exit Routes
  • Electrical
  • Emergency Action Plan
  • Fire Safety
  • Medical and First Aid
  • Needlestick Safety and Prevention
  • Infection Control

These are very broad categories that encompass many sub elements.  For example, OSHA Mandates that under the Bloodborne Pathogens Standard:  

OSHA’s Bloodborne Pathogens Standard (29 CFR 1910.1030) requires employers to provide information and training to workers. Employers must ensure that their workers receive regular training that covers all elements of the standard including, but not limited to information on bloodborne pathogens and diseases, methods used to control occupational exposure, hepatitis B vaccinations, and medical evaluation, including post-exposure follow-up procedures. Employers must offer this training on initial assignment, at least annually thereafter, and when new or modified tasks or procedures affect a worker’s risk of occupational exposure.

Do you think our fictitious office will be cited for a violation of not providing Bloodborne Pathogens training to its employees?  Absolutely Yes.  What can be the fine amounts for such a violation?  According to OSHA maximum penalties for serious and other-than-serious violations will increase from $14,502 per violation to $15,625 per violation.

Lets take a look at another possible citation that could arise out of this OSHA inspection.  Next stop is the Laboratory.  As Mr. Johnson from OSHA enters the lab, he notices a coffee cup on the counter and an opened bag of potato chips.  Is this allowed?  Employees have to be allowed to eat and drink, don’t they?

According to OSHA regs: OSHA’s bloodborne pathogens standard prohibits the consumption of food and drink in areas in which work involving exposure or potential exposure to blood or other potentially infectious material takes place, or where the potential for contamination of work surfaces exists [29 CFR 1910.1030(d)(2)(ix)].

Will the lab meet the definition of a potentially “Contaminated area”?  Absolutely Yes.  Tack on another potential fine to the total.

Our last example brings us to a container of Cavicide that an employee is using to decontaminate an exam room.  Mr. Johnson approaches the employee and asks her where she can access a Safety Data Sheet (SDS) for Cavicide.  The employee has no idea what a Safety Data Sheet is, and definitely doesn’t know how to get one.  What does OSHA say about employee access to SDSs?

The employer shall maintain in the workplace copies of the required safety data sheets for each hazardous chemical, and shall ensure that they are readily accessible during each work shift to employees when they are in their work area(s) (29 CFR 1910.1200, paragraph(g)(8).)

Employees having no access to the required Safety Data Sheets will absolutely result in a violation and fine.  We are just getting started on our fictious OSHA inspection and the violations and potential fines keep growing.  What will be the final outcome?  Only time will tell, and only after part three, the Closing Conference.

OSHA Fact Sheet; Great resource!

https://www.osha.gov/sites/default/files/publications/bbfact01.pdf