Nursing homes are one of the hardest-hit areas in our society when it comes to COVID-19.

Are Nursing Home Residents and Employees at Risk?

As we continue to navigate the public health crisis that is COVID-19, it is worth looking at one of the most at-risk groups: the elderly in long-term nursing care facilities. In many states, the nursing homes are ravaged by this deadly, infectious disease. OSHA is involved in some aspects of care within these facilities.

Let us look at what makes nursing homes so high-risk, the citations that OSHA has issued, and what resources are available to nursing homes to mitigate this health crisis.

According to the NCBI, nearly half of all the deaths that occurred in the first wave of COVID-19 came from nursing homes. The NCBI found that not only did the virus affect the patients, but the lockdowns and prevention of visitors caused a cognitive decline, depression, anxiety, and other issues.

Moreover, according to the CDC’s National Healthcare Safety Network, there are have 332K confirmed cases of COVID-19 with another 165K suspected, all of which has resulted in 70K deaths to date or nearly 1/4th of all COVID deaths since the start.

The reason that long-term care facilities have been hit so hard is because of the condition of the residents. Most of them are very old, have multiple co-morbidities, are immunocompromised, and also very frail.  Considering that most residents already suffer from moderate to severe dementia, they do not understand social isolation, which leads to a more rapid decline (Pitkala, 2020).

Just outside of Pittsburgh, PA, in Beaver, a facility called Brighton Rehab faced one of the worst outbreaks of COVID-19 that was seen in the U.S. among nursing homes. This facility has the risks mentioned above and experienced a severe lack of leadership, cleanliness, and adherence to CDC guidelines of infection control.

During the early onset of the pandemic, Brighton Rehab saw 73 resident deaths and a housekeeper die from COVID-19 from March-May 2020. (Martines, Nordstrom, 2020).

The outbreak was so bad that the Pennsylvania National Guard was called in to assist with cleaning and patient care at one point. There has been a change to how the facility is run, and new COVID mitigation protocols are in place, but the residents and families feel it is too little too late. In September, the Department of Health and Human Services sent the FBI in to investigate a criminal allegation of negligence and unauthorized use of treatment drugs.

The scenario with Brighton Rehab spurred on a call for federal scrutiny for all nursing homes across the country. This effort was championed by P.A. Senators Bob Casey and Pat Toomey. (Lindstrom, 2020). As this pandemic progresses, we are sure to see more changes and reforms to nursing home care as a result.

Existing OSHA standards already cover pandemics like COVID-19.

OSHA has also been monitoring the situation at nursing homes across the U.S. According to the OSHA General duty clause, “Each employer shall furnish to each of his employees’ employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees” (OSHA Act of 1970 Section 5, (a)(1)). This clause would include a duty to protect workers from COVID-19 and provide mitigation efforts to protect employees.

OSHA has also cited a Cleveland-area nursing home with proposed penalties of $40,482 for allowing N95 respirator use for up to seven days and not conducting initial fit testing (Department of Labor, 2020). OSHA has cited 37 healthcare facilities for COVID-19 safety violations since the beginning of the pandemic (as of 7 October 2020).

Failure to implement a written respiratory protection program, failure to provide fit tests and medical evaluations for respirator usage, and reporting illnesses and fatalities are the primary violations warranting the citations. As the pandemic continues, we can expect OSHA to issue more of these citations to healthcare facilities. (Masson, 2020)

Healthcare facilities may be feeling overwhelmed by the responsibilities with the response to COVID-19. There are many facets of safety and health that can present many challenges.

Thankfully, there are many resources available to help these facilities be as safe as possible.

One of the most powerful yet underutilized tools to prevent workplace injuries are mock OSHA inspections.

Having a qualified professional take a look at your facility or job site can help identify workplace safety issues unnoticed by the everyday person. When discussing healthcare facilities and COVID-19, these inspections can ensure that all of the proper protocols are being followed, including respiratory programs, fit testing, and illness/fatality reporting.

  • Lancaster Safety is proud to offer this as part of our OSHA compliance service offering.
  • The Centers for Medicare & Medicaid Services (CMS) also has a full manual with tips on mitigation actions in nursing homes.
  • The American Hospital Association also has a wide variety of resources on its website (www.aha.org) that can benefit healthcare facilities.

The COVID-19 pandemic is not going anywhere anytime soon. In the U.S., the cases are still increasing, and our daily death numbers are not decreasing. Our hospitals and nursing homes are going to face more challenges as this pandemic goes on. By working together, we can overcome these challenges to safety by following the CDC guidelines, obeying the OSHA standards, and making extra efforts to ensure that employees are kept safe.

If you own a nursing home and want to prioritize the safety and health of your residents and employees, set up a Mock OSHA Inspection with us today by calling (724) 776-1003.

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