OSHA Inspection: INTEGRA HEALTH MANAGEMENT, INC.

Issued

Jun 6, 2013

Abate by

Jun 14, 2013

Penalty

Initial $7,000 · Current $7,000

General-duty citation text

OSH ACT of 1970 Section (5)(a)(1): The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employees, in that employees were exposed to the hazard of being physically assaulted by members with a history of violent behavior:    a)  On or about December 10, 2012, an employee providing healthcare management services was fatally stabbed by a member with a violent criminal history.  Employees acting as service coordinators regularly interacted on their own directly with members with a history of violent behavior.    Among other methods, feasible means to abate this hazard include:   1. Create a stand-alone written Workplace Violence Prevention Program for all the service programs which include the following elements:     ? A Workplace Violence Policy Statement including responsibilities of all staff and a policy that workplace violence will not be tolerated and every incident will be investigated; ·  Implement a real-time log-in/log-out system; ? Hazard/Threat/Security assessment including records review, employee survey. and evaluation of the worksite for a safe means of egress and potential restrictions; ? Training and education of all staff with a focus on the specifics of the Integra Program;  ? Incident reporting and investigation;  ? A system for reporting safety concerns internally;  ? Periodic review of the program; ? Ensuring employee involvement and input from direct care staff in all aspects of its Workplace Violence Prevention Program;   ? Soliciting employee input from direct care staff from all parts of Integra?s operation; and   ? Having a Safety Committee that includes direct care staff as full committee members.     2. Determine the behavioral history of new/transferred members; establish a system ? such as chart tags, log books, and/or verbal census reports ? to identify members with assaultive behavior problems (including threats of violence) and to communicate such pertinent information to all potentially exposed employees; train all staff to understand the flagging system; and have a system for holding members accountable for violent behavior through consequences or interventions.  3. Put procedures in place that would communicate any incident of workplace violence to all affected staff who could potentially be exposed to the member(s) involved in the violent incident in a timely manner, so that employees who might not have access to members' charts would be aware of a member?s previous acts of violence or aggression. 4. Ensure that training is sufficient to make all employees aware of the company workplace violence policy, and how that written policy can be accessed.  Training shall also include, but not be limited to:   ? Instructing all employees to state clearly to members that violence is not permitted or tolerated;  ? Training all employees on effective methods for responding during a workplace violence incident;  ? Training all employees on recognizing aggressive behavior exhibited by members or others, and on techniques for timely de-escalating the behavior;  ? Instructing all employees about risk factors that cause or contribute to assaultive behaviors (including threats of violence);  ? Training all employees to report all incidents of workplace violence, including assaults and threats of assaults, and instructed that such reporting is mandatory; and  ? Training shall be conducted at orientation before employees are exposed to members, and annually as refresher training. 5. Implement and maintain a buddy system as appropriate based upon a complete hazard assessment which includes procedures for all staff to request and obtain double coverage when necessary, including but not limited to situations where an employee communicates that he or she feels unsafe being alone with a particular member.   6. Provide all staff with a reliable way to rapidly summon assistance when needed, such as an electronic alarm and/or walkie-talkies, including when an employee is with a member in the community and/or transporting a member in a vehicle.  7. Establish a liaison with law enforcement representatives.

Issued

Jun 6, 2013

Abate by

Jun 10, 2013

Penalty

Initial $3,500 · Current $3,500

General-duty citation text

29 CFR 1904.39(a):   The employer did not orally report the death of an employee or the in-patient hospitalization of three or more employees because of a work-related incident:  a. 37020 Coleman Avenue Apartment 1 Dade City, Florida - the employer failed to report a work-related fatality to OSHA.  Violation observed on or about 12/13/12.