Nursing home safety initiative and existing employer duties

NOTICE: This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only.

December 31, 1996

Mr. Edward Stafford
New York State Health
Facilities Association
[Recipient address omitted]

Mr. Carl Young
New York Association of Homes
And Services for the Aging
[Recipient address omitted]
Dear Gentlemen:

This letter responds to your inquiry of August 27, regarding the Occupational Safety and Health Administration's (OSHA) Nursing Home Safety and Health Initiative. We regret the delay in providing this response.

The first concern stated in your letter regards the use of "scare tactics" in the publicizing of the initiative. It is never OSHA's intent to use scare tactics in any form. Our goal is to provide the data and information upon which our initiative is based. The Bureau of Labor Statistics data which were quoted in Secretary of Labor Robert B. Reich's announcement of August 3, lists the nursing home industry as having significantly higher employee injury and illness rates than many other industries.

As your letter points out, this data may be subject to different interpretations by interested parties. However, OSHA interprets this data to mean that nursing homes may have unaddressed hazards which are leading to unacceptably high injury and illness rates. Our publicizing of the Nursing Home Safety and Health Initiative would be remiss if we did not state that our concern is founded on data, and that the safety and health hazards causing the elevated rates need to be addressed. None of OSHA's concern is meant to cast any negative aspersions upon areas of nursing home operations beyond the scope of OSHA's mandate, the safety and health of the employees.

The second concern regards the outreach program's educational content and the resources devoted to this component. As part of the development process for this Initiative, OSHA determined to provide a one-day outreach session in each of seven states with a high number of nursing home facilities. In the development of the initiative, OSHA sought the input of stakeholders to ensure the development of an outreach program that would meet the needs of the nursing home industry. The American Association for Homes and Services for the Aging provided valuable information and insights about the characteristics of the industry as well as areas of concern for the industry. The Agency relied on this type of input in setting an agenda that is oriented around safety and health issues and OSHA policies and practices that effect nursing homes. Hence, the outreach program is presented by OSHA personnel. The mention of residents' rights in the outreach program is meant to recognize this aspect of the industry and is not meant to usurp other regulatory agencies' authority. OSHA is considering whether additional outreach sessions are necessary in the future based upon an evaluation of the seven sessions.

The Agency regards this initiative as a measured response to reduce the risk to employees by encouraging the development and implementation of comprehensive safety and health programs. The assertion that the industry is being held accountable to standards which were not in effect prior to this initiative or only introduced at the outreach sessions is unfounded. OSHA expects that employers are complying with all applicable OSHA regulations and the general duty requirement of the OSH Act to maintain a workplace free from recognized serious hazards. This information has always been publicly available. The information covered by the outreach sessions encourages a proactive approach wherein employers can address their hazards and sources of injuries and illnesses in a proactive manner. These employers will find that OSHA is a willing partner to assist them in their program.

The Agency recognizes that the outreach sessions and enforcement efforts are only a part of the solution to a very complex problem. Concerned organizations such as yours play a vital role in addressing the occupational safety and health issues facing the nursing home industry. I understand that your difficulties in contacting an OSHA representative to discuss the program have been resolved. If you have any further questions regarding the program, please contact your Regional Nursing Home Coordinator, Robert Garvey at (212) 337-2378. We look forward to continue working with you in the future. Thank you for your interest in safety and health.

Sincerely,

John B. Miles, Jr., Director
Directorate of Compliance Programs

[Requester letter reproduced on OSHA page; omitted here.]