OSHA Enforcement

This section directs employers and employees to OSHA enforcement initiatives (i.e., special emphasis programs) and selected policy guidance documents that pertain to nursing and residential care facilities.

Initiatives

• National Emphasis Program - Nursing and Residential Care Facilities. OSHA Instruction CPL 03-00-016, (2012, April 5). Implements an NEP for programmed inspections of nursing and residential care facilities within NAICS 623110, 623210 and 623311 (formerly SIC codes 8051-Skilled Nursing Care Facilities, 8052-Intermediate Care Facilities, and 8059-Nursing and Residential Care Facilities, Not Elsewhere Classified)].
  
  
• Site-Specific Targeting 2012 (SST-12) [524 KB PDF^*, 41 pages]. OSHA Notice 13-01 (CPL 02), (2013, January 4). Implements OSHA's Site-Specific Targeting 2012 (SST-12) inspection plan, and replaces the September 9, 2011 Notice that implemented OSHA's Site-Specific Targeting 2011 (SST-11) inspection plan. This program does not include construction worksites.

Directives

The following are selected OSHA Directives and Instructions which provide guidance on the agency's enforcement procedures, explain OSHA's requirements, and describe how they apply in a particular situation.

• Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens. CPL 02-02-069 [CPL 2-2.69], (2001, November 27). Includes revisions mandated by the Needlestick Safety and Prevention Act.
• Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis [333 KB PDF, 67 pages]. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 50(RR11), (2001, June 29). Updates and consolidates recommendations for the management of health-care personnel (HCP). Serves as Appendix E for CPL 02-02-069.
• Updated U.S. Public Health Service for the Management of Occupational Exposure to HIV and Recommendations for Postexposure Prophylaxis. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 54(RR09); 1-17, (2005, Sept. 30). Updates previous recommendations for the management of health-care personnel (HCP) who may have been occupationally exposed to HIV.
  
  
• Enforcement Procedures for Investigating or Inspecting Workplace Violence Incidents. CPL 02-01-052, (2011, September 8). Establishes general policy guidance and procedures for field offices to apply when conducting inspections in response to incidents of workplace violence.
  
  
• Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis. CPL 02-00-106 [CPL 2.106], (1996, February 9). Provides uniform inspection procedures and guidelines to be followed when conducting inspections and issuing citations under Section 5(a)(1) of the OSH Act and pertinent standards for employees who are occupationally exposed to TB.
  
  
• Search all available directives.

Standard Interpretations

The following are selected letters of interpretation which explain OSHA's requirements and how they apply in a particular situation. Note that enforcement guidance may be updated in response to new information and affected by changes to OSHA rules. To keep informed about such developments, you can visit OSHA's website. Example letters are listed below.

• Applicability of OSHA's bloodborne pathogens standard to the containment and disposal of electric razors in correctional facilities and health care settings. (2008, January 2).
  
  
• Containment and disposal requirements for disposable razors used in long-term health care facilities for personal grooming. (2005, March 28).
  
  
• Tuberculosis and Respiratory Protection. (2004, July 30). Defines the updated enforcement policy for tuberculosis under 29 CFR 1910.134. Effective July 2, 2004, covered establishments must comply with 29 CFR 1910.134 when using respirators for protection from tuberculosis (TB).
  
  
• Safer medical devices must be selected based on employee feedback and device effectiveness, not Group Purchasing Organizations. (2002, November 21).
  
  
• Use of height adjustable beds help reduce back injuries during patient care. (2000, June 15).
  
  
• Bloodborne pathogens standard requirements regarding employees performing residential services. (1992, September 4).
  
  
• Application of provisions of the Bloodborne Pathogens standard to Funeral and Nursing Homes. (1992, June 1).
  
  
• Search all available standard interpretations.

Ergonomics Enforcement

• Ergonomics Enforcement Safety and Health Topic Page. Serious ergonomics hazards in nursing and residential care facilities will be addressed using Section 5(a)(1) of the OSH Act, often referred to as the General Duty Clause.

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^*These files are provided for downloading.