OSHA Protections—or Lack Thereof—for Nursing Home Staff

In the late 1990’s when I was working as an interim administrator at a long-term care facility, the facility was sued by the Occupational Safety and Health Administration (OSHA). The fine was a result of calculations that the facility had excessive numbers of staff who had sustained back injuries.  A negotiated settlement was reached to my relief.  I have to admit that at the time, I had no idea that OSHA had a jurisdiction over skilled nursing facilities, or that reports of back injuries were being tracked by the agency.

In a recent article by Eyal Press in The New Yorker,¹ Mr Press examines the current climate at OSHA in the wave of COVID-19. This past April, the president of the AFL-CIO union, Richard Trumka, sent a letter to Eugene Scalia, the Secretary of Labor. The letter accused the Department of risking the health of millions of essential workers. Mr Trumka demanded that OSHA develop emergency safety guidelines that would require businesses to follow specific rules in conjunction with the Centers for Disease Control. Mr Scalia replied that he believed such emergency standards were unnecessary.

Since the pandemic began, OSHA has received an excess of ten thousand complaints related to unsafe working conditions involving COVID-19.  As a result, the agency has issued only two citations. The Labor Department instead released a memorandum on April 10, 2020 that relieved employers from tracking or reporting “work-related” COVID-19 infections.  Given the nature of this virus, it is not possible to know with certainty whether the employee contracted COVID-19 at work or from the community as many people are asymptomatic or pre-symptomatic when testing positive.  The lack of a mandate for businesses to track is an epidemiologic nightmare.  Nursing homes are an exception to this rule but of course our employees live, eat, shop and function outside of our facilities. Community spread necessarily means that our residents and staff will experience COVID-19 infections.

We all eschew rules, regulations and governmental overreach as arbitrary and capricious.  We work under layers of nursing home regulations from federal, state, and local jurisdictions and we always attempt to comply with these rules for the health and safety of our residents as well as for the sake of compliance and the avoidance of Civil Monetary Penalties that are assessed when significant non-compliance is alleged. 

In this case, we need more governmental oversight to protect the community at large, employees who work in fields other than health care, and specific rules to follow in order to decrease the spread of COVID-19 among nursing home residents and staff.

Ilene Warner-Maron, PhD, RN-BC, CWCN, CALA, NHA, FCPP, is an assistant professor in the Department of Geriatrics and Palliative Medicine at the Philadelphia College of Osteopathic Medicine. Dr Warner-Maron is also the executive director of the Eastern Pennsylvania Geriatric Society.  

Reference:

1. Press, Eyal. Trump’s Labor Secretary Is a Wrecking Ball Aimed at Workers. The New Yorker. https://www.newyorker.com/magazine/2020/10/26/trumps-labor-secretary-is-a-wrecking-ball-aimed-at-workers. Published Online October 19, 2020.