OSHA Inspection: JACKSONVILLE HEALTH AND REHABILITATION, L.L.C.

Issued

Aug 16, 2004

Abate by

Jan 31, 2006

Penalty

Initial $4,500 · Current $4,500

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970:  The
employer did not
furnish employment and a place of employment which were free from
recognized hazards that
were causing or likely to cause serious physical harm to employees in that
employees were
performing tasks that have caused or likely to cause musculoskeletal
disorders (MSDs):
a)On or about January 5, 2004, and at times prior thereto, and continuing
to June 28,
2004, employees, including the Certified Nursing Assistants who work at
Jacksonville
Health Rehabilitation Center in Jacksonville, Alabama performed repeated
lifting/lowering, pushing, pulling, bending, reaching, twisting, and other
tasks associated
with resident transfers and repositioning.  These actions, performed by
employees to
manually transfer and/or reposition partial weight-bearing residents and
non-weight
bearing residents, exposed employees to hazards which had caused, are
causing, or are
likely to cause musculoskeletal disorders (MSDs) involving the back and
shoulders.
Abatement:  Although some ergonomic-related risk factors may be reduced or
eliminated by
implementing a single means of abatement, in most cases, a process that
includes analysis of the
worksite, instituting appropriate controls, providing appropriate response
to employee injuries,
and training and education (in both recognition of hazard and injury and
of avoidance of injury)
will provide the most effective method of addressing the risk factors.
The employer may adopt
any measures that are effective in substantially reducing or eliminating
the hazard.
Abatement controls include engineering, training and education, and
administrative and work
practice controls.
Engineering Controls:  Some examples of engineering controls include: The
availability, use
of an adequate number of mechanical lift-assist devices, as well as,
transfer and repositioning
devices, which include, but are not limited to: low-friction slip sheets,
pivot transfer devices,
slide boards, double-handled gait belts, as well as, specialized equipment
for use with residents
with special needs (i.e., bariatric residents).
Training and Education:  Examples of training and education include:
Providing training to
new employees and retraining to existing employees who are responsible for
transferring and
repositioning residents, stressing the importance of reporting
musculoskeletal injuries, providing
regular feedback to injured employees on corrective actions in order to
prevent future injuries,
training in the appropriate use of mechanical lift-assist, transfer, and
repositioning devices, and
training in identifying and reporting malfunctioning lift-assist equipment
or any other conditions
that could cause or contribute to injuries to the employees.
Administrative Controls:  Examples of administrative controls that may
apply to this facility
include: 1.  Develop and implement a preventive maintenance program to
ensure
that all
mechanical lift and transfer devices are properly maintained and promptly
repaired. 2. Develop
and enforce a policy requiring the use of transfer and repositioning
devices when a resident's
care plan documents the need. 3.  Assure that the resident's care plan
addresses transfer and
positioning assistance needs, and that the CNAs are aware of such needs.
The care plan must
be kept current.  4.  Develop a plan for the replacement of  manually
operated beds with power
operated beds.Work Practice Controls:  Some examples of work practice
controls that may apply to this
workplace include: Monitor resident repositioning to ensure that, where
required, it is performed
by a minimum of two persons in accordance with company policy.  Manual
lifting of totally
dependent residents by nursing staff should be prohibited unless
exceptional circumstances dictate
otherwise, for example, emergency situations or medical necessity, or
resident refusal to allow
the use of such devices.