Nursing Homes Shortchanged in OSHA Inspection Targeting Program

OSHA announced its 2004 site-specific targeting (SST) plan earlier this week. The SST will focus on approximately 4,000 high-hazard worksites.

This year's program is effective April 19 and will initially cover about 4,000 individual worksites on the primary list that reported 15 or more injuries or illnesses resulting in days away from work, restricted work activity, or job transfer for every 100 full-time workers (known as the DART rate). The primary list will also include sites based on a "Days Away from Work Injury and Illness" (DAFWII) rate of ten or higher (ten or more cases that involve days away from work per 100 full-time employees).

OSHA will once again add nursing homes to the SST. For the past two years, nursing homes were covered instead under a separate National Emphasis Program that OSHA abruptly cancelled last year.

The "National Emphasis Program for Nursing and Personal Care Facilities" was an attempt by OSHA to show that it was serious about ergonomics. Nursing home workers, as Henshaw said, had 2 1/2 times as many injuries and illnesses as private sector workers. And over half of those injuries are from overexertion and other ergonomic problems. (And just to put all of this in perspective, OSHA estimated during the Clinton administration ergonomic hearings that only around one-half of all ergonomic injuries were even reported.)

Nursing homes had been part of OSHA's regular "Site Specific Targeting" program. In fact, 2500 nursing and personal care facilities, out of a total of 13,000 in the private sector, were notified by OSHA last year that their injury and illness rates were higher than average and that they therefore had a higher than average chance of being inspected. Approximately 800 nursing homes would have been inspected under the targetting program, but Henshaw announced that under the NEP, 1000 would be inspected.

Although a central focus of the the NEP was ergonomics, OSHA only had a handful of citations and paltry fines to show for itself at the conclusion of the program.

But too many nursing home still have DART and DAFWII rates that qualify for targeted inspections in 2004, so instead of inspecting all of the nursing homes that have high enough injury and illness rates (as it does with all other industries), OSHA has decided that

Only the highest 50% rated establishments in these three SIC Codes with either a DART rate at or above 15.0 or a DAFWII case rate at or above 10.0 are included in the Primary List. No establishments in these three SIC Codes are added to the Secondary List.

The Secondary List includes businesses with slightly lower rates that are inspected when an area office finishes the primary list early.

OSHA's logic never fails to mystify me: Because there are so many hazardous nursing homes, we are only going to inspect half as many as other, less hazardous industries. And even if you finish your first list, instead of inspecting the other half of the nursing homes that were left off the list, you have to inspect other industries that have even fewer injuries.