Effective March 12, 2021, the Occupational Safety and Health Administration (OSHA) announced a national emphasis program to focus on enforcement efforts related to COVID-19 hazardous conditions and has targeted the long term care sector under this directive. This directive provides L&I’s Division of Occupational Safety and Health (DOSH) program with the authority to walk into a facility and perform an inspection, solely on the basis of the program emphasis. Facilities should be prepared for an inspection from DOSH, and should take some time to review their current COVID-19 protocols, as they relate to worker safety. WHCA and ERNWest have received numerous reports from facilities around the state that are finding themselves subject to these inspections. Here is what we have learned:
What are DOSH inspectors specifically looking for?
Documentation for the following items:
- Respiratory Protection Program. A written copy of your program must be provided. EVERY facility should have this document in place, along with a system for fit testing. If you have employees in your facility that interact with any COVID positive residents, they MUST be protected with a tight-fitting (N95) type respirator. Any employee who must wear a tight fitting respirator must be fit-tested prior to donning their N95 mask. Make sure you’ve done everything possible to source appropriate PPE and have a fit testing kit on hand. Make sure to document these efforts and show inspectors proof if you’ve had difficulty obtaining these supplies in the past.
- Fit testing documentation and medical evaluation forms. For facilities that performed these procedures in-house, make sure you have the correct documentation. Medical evaluation forms should be filled out and signed by a licensed healthcare provider or registered nurse whose scope of practice allows for this type of evaluation. Inspectors may question the RN on their knowledge of respiratory hazards. Make sure your RN has the proper qualifications to perform the medical evaluation.
- OSHA 300 logs for 2020 and 2021. Inspectors will access your OSHA 300 logs and will ask you for instances of infected staff and residents. If you fail to record a case as “work related,” you should expect to have these logs scrutinized. OSHA has guidance on their website on how to determine if a work-related exposure contributed to a positive COVID-19 case.
- Program review. What does your written COVID-19 plan look like, and how do you plan to protect your workers in the event of an outbreak? What is your plan for distributing PPE to affected workers?
- Use of airborne isolation areas. Have you created a space for COVID-19 positive residents to be housed outside of the general facility areas? What does your isolation area look like? Employees should be trained and familiar with these protocols.
- Employee roster, to include names, title, shift worked, personal phone number and emails for the purpose of conducting employee interviews. Make sure to document when employees tested positive and/or showed COVID-19 symptoms.
- Job descriptions for caregivers.
- Picture of N95 respirators used. What are the brand and model numbers?
- Decontamination procedure for re-use of N95 respirators.
- Type of hand sanitizer used in your facility.
