OSHA Inspection: BROOMFIELD SKILLED NURSING & REHABILITATION CENTER LLC

Issued

2013-08-23 00:00:00

Abate by

2013-10-27 00:00:00

Penalty

Initial $6300.00 · Current $6300.00

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 death or serious physical harm to employees in that employees were required to perform resident transferring and other handling tasks resulting in stressors that have caused or were likely to cause musculoskeletal disorders:  (a) Broomfield Skilled Nursing & Rehabilitation Center LLC, at 12975 Sheridan Boulevard, Broomfield, CO: On and preceding 2/26/13, employees were exposed to musculoskeletal injury hazards which were causing back, shoulder, neck and other upper and lower extremity sprains and strains.  Employees, including but not limited to Certified Nursing Assistants (CNA's), were required to transfer non-weight bearing and partial weight bearing residents manually, using one or two person gait belt lifts rather than using mechanical assistive devices.  Employees were also exposed to other hazards such as repeated lifting/lowering, pushing, pulling, bending, reaching, twisting, ambulating and other tasks associated with resident transfers and repositioning which resulted in recordable injuries, including lost work time and restricted work activity.    Abatement: Although some ergonomic-related risk factors may be reduced or eliminated by implementing a single means of abatement, in most cases a combination of engineering, work practice and administrative controls 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.  Some control options that have been found to be feasible methods for materially reducing the hazard at other facilities that you may consider are detailed as follows:  Engineering controls:  Effective engineering controls reduce the amount of force exerted to lift, lower, push, and pull.  Controls should also reduce awkward postures such as reaching, and twisting and ideally reduce the number of times that repetitive tasks are performed.  Ensure that high-risk resident handling tasks are completed safely using mechanical lifting devices or other appropriate equipment together with proper techniques. Provide appropriate equipment with appropriate slings for the tasks, in a variety of sizes, to support lift, transfer, ambulation and repositioning for the residents. Care providers should not lift more than 35 pounds of the resident's body weight. Provide the number of lifts to ensure safety of the direct care provider using the general guideline of one full dependency lift for every 8 to 10 partial weight bearing residents. Full dependency lifts should be available to assist residents in getting up from off the floor in the event of a fall. Support the use of mechanical lifting devices to assist with repositioning patients in bed and iwth transfer tasks.   Administrative Controls:  Develop a site-specific comprehensive safe resident handling program to eliminate manual lifting as much as possible. Ensure that the lifting, transferring, repositioning and ambulatory needs of all residents are assessed. Such assessments should be included in the resident care plan. All staff responsible for moving residents must be trained on the appropriate use of nursing assessments and the appropriate equipment; daily scan/check procedures to ensure that residents ability can function as expected under their care plan; and on the correct procedures for lifting, transferring, repositioning and ambulating residents. Recognize and identify all existing ergonomic stressors related to manual resident handling and identify manual resident handling tasks that are causing or likely to cause injury. The policy should ensure that the residents are moved safely while encouraging resident mobility and independence and that residents are reassessed if their conditions change, especially for long-term residents, to adequately capture changes in their health or cognitive status. Ensure that all management and staff are knowledgeable in their roles and responsibilities required in the resident handling program. Incorporate NIOSH's ergonomic recommendations for nursing homes into this program. Perform audits to ensure appropriate transfers, assists, use of assistive devices and proper body mechanics are utilized.     Work Practice Controls: Establish a "minimal lift" policy that prohibits manual lifting unless manual lifting is specifically authorized for the resident. Use gait belts at best for stand-by assists only. Re-evaluate residents as appropriate to eliminate manual transfers.  Training and Education: Provide training to all staff on all shifts responsible for safe resident lifting program and include administrators, nursing staff, physical and occupational therapy staff, maintenance staff and the direct care providers. Ensure that all staff affected by the policy receives training. Provide training to direct care providers in order that they are made competent in the procedures and use of resident lifting, transferring, repositioning and ambulation assistive equipment and slings. Document training and annual re-training. Provide educational material or porcedures and purchasing equipment. Maintain all training records. Provide re-training as needed to assure the proper use of mechanical lifts and other assist devices.

Issued

2013-08-23 00:00:00

Abate by

2013-09-27 00:00:00

Penalty

Initial $2295.00 · Current $1195.00 Reduced

General-duty citation text

29 CFR 1910.151(c): Where employees were exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body were not provided within the work area for immediate emergency use:    Broomfield Skilled Nursing & Rehabilitation Center LLC, at 12975 Sheridan Boulevard, Broomfield, CO:  On and preceding 2/26/13, Broomfield Skilled Nursing & Rehabilitation Center LLC did not ensure that where employees were exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body were provided within the work area for immediate emergency use.  Employees used EcoLab Laundri Destainer (containing 8.4% sodium hypochlorite) when performing laundry duties.  Sodium hypochlorite is a corrosive liquid.  The nearest emergency eyewash was located in the kitchen, through two laundry doors, down a hall, and through the kitchen door.  The employer did not ensure that an emergency eyewash was provided in the laundry room.  This condition exposed employees to a corrosive liquid hazard.

Issued

2013-08-23 00:00:00

Abate by

2013-10-28 00:00:00

Penalty

Initial $2295.00 · Current $1195.00 Reduced

General-duty citation text

29 CFR 1910.1030(c)(1)(iv): The Exposure Control Plan was not reviewed and/or updated annually:    (a) Broomfield Skilled Nursing & Rehabilitation Center LLC, at 12975 Sheridan Boulevard, Broomfield, CO:  On and preceding 2/28/13, Broomfield Skilled Nursing & Rehabilitation Center LLC did not ensure that the Exposure Control Plan was reviewed and/or updated annually.  Nurses and Certified Nursing Assistants (CNA's) care for patients and residents of a skilled nursing center.  The employer has determined that the nurses and CNA's were occupationally exposed to blood and/or other potentially infectious materials (OPIM).  The employer had developed an Exposure Control Plan.  The employer did not review or update the ECP annually.  This condition exposed employees to a bloodborne pathogen hazard.    (b) Broomfield Skilled Nursing & Rehabilitation Center LLC, at 12975 Sheridan Boulevard, Broomfield, CO:  On and preceding 2/28/13, Broomfield Skilled Nursing & Rehabilitation Center LLC did not ensure that the Exposure Control Plan was reviewed and/or updated annually.  Nurses used syringes, lancets, IV systems, and blood collection devices while caring for patients and residents of a skilled nursing center.  The employer has determined that the nurses and CNA's were occupationally exposed to blood and/or other potentially infectious materials (OPIM).  The employer had developed an Exposure Control Plan.  Needlesticks have occurred in the workplace.  The employer did not perform annual consideration and implementation of appropriate commercially available and effective safer medical devices designed to eliminate or minimize occupational exposure.  This condition exposed employees to a bloodborne pathogen hazard.

Issued

2013-08-23 00:00:00

Abate by

2013-09-27 00:00:00

Penalty

Initial $0.00 · Current $0.00

General-duty citation text

29 CFR 1910.1030(g)(2)(vii)(F): The bloodborne pathogens training program did not contain an explanation of the use or limitations of methods that would prevent or reduce exposure including appropriate engineering controls, work practices or personal protective equipment:    Broomfield Skilled Nursing & Rehabilitation Center LLC, at 12975 Sheridan Boulevard, Broomfield, CO:  On and preceding 2/28/13, Broomfield Skilled Nursing & Rehabilitation Center LLC did not ensure the bloodborne pathogens training program contained an explanation of the use or limitations of methods that would prevent or reduce exposure including appropriate engineering controls, work practices or personal protective equipment.  Nurses used syringes, lancets, IV systems, and blood collection devices while caring for patients and residents of a skilled nursing center.  The employer has determined that the nurses and CNA's were occupationally exposed to blood and/or other potentially infectious materials (OPIM).  Needlesticks have occurred in the workplace.  The employer did not provide annual bloodborne pathogens training with regards to the medical devices used by nurses.  This condition exposed employees to a bloodborne pathogen hazard.

Issued

2013-08-23 00:00:00

Abate by

2013-09-27 00:00:00

Penalty

Initial $2295.00 · Current $1195.00 Reduced

General-duty citation text

29 CFR 1910.1030(d)(2)(i): Engineering and work practice controls were not used to eliminate or minimize employees exposure:    Broomfield Skilled Nursing & Rehabilitation Center LLC, at 12975 Sheridan Boulevard, Broomfield, CO:  On and preceding 2/28/13, Broomfield Skilled Nursing & Rehabilitation Center LLC did not ensure that engineering and work practice controls were used to eliminate or minimize employees exposure.  Nurses used pen type lancets while doing blood sugar checks of a resident of a skilled nursing center.  After use, the contaminated lancet tip was removed and carried to the sharps container, where the contaminated sharp was disposed.  The employer did not ensure that engineering controls in the form of safety lancets were used.  This condition exposed employees to a bloodborne pathogen hazard.

Issued

2013-08-23 00:00:00

Abate by

2013-09-27 00:00:00

Penalty

Initial $0.00 · Current $0.00

General-duty citation text

29 CFR 1910.1030(d)(2)(vii)(A): Contaminated needles and other contaminated sharps were bent, recapped, or removed:    Broomfield Skilled Nursing & Rehabilitation Center LLC, at 12975 Sheridan Boulevard, Broomfield, CO:  On and preceding 2/28/13, Broomfield Skilled Nursing & Rehabilitation Center LLC did not ensure that contaminated needles and other contaminated sharps were not bent, recapped, or removed.  Nurses used pen type lancets while doing blood sugar checks of a resident of a skilled nursing center.  After use, the contaminated lancet tip was removed and carried to the sharps container, where the contaminated sharp was disposed.  The employer did not ensure that contaminated sharps were not removed.  This condition exposed employees to a bloodborne pathogen hazard.

Issued

2013-08-23 00:00:00

Abate by

2013-09-27 00:00:00

Penalty

Initial $0.00 · Current $0.00

General-duty citation text

29 CFR 1910.1030(d)(4)(iii)(A)(2)(i): During use, containers for contaminated sharps were not easily accessible to personnel or located as close as was feasible to the immediate area where sharps were used or could be reasonably anticipated to be found:    Broomfield Skilled Nursing & Rehabilitation Center LLC, at 12975 Sheridan Boulevard, Broomfield, CO:  On and preceding 2/28/13, Broomfield Skilled Nursing & Rehabilitation Center LLC did not ensure that during use, containers for contaminated sharps were easily accessible to personnel or located as close as was feasible to the immediate area where sharps were used or could be reasonably anticipated to be found.  Certified Nursing Assistants (CNA's) used disposable razors when caring for residents at the long term care center.  After use, the contaminated sharps were carried from the interior of the resident's room, through the door and to the med cart or shower cart, up to ten feet away, where the contaminated sharp was disposed in a sharps container after unlocking the cart cabinet door.  The employer did not ensure that sharps containers were located as close as feasible to where the sharps were used.  This condition exposed employees to a bloodborne pathogen hazard.

Issued

2013-08-23 00:00:00

Abate by

2013-09-27 00:00:00

Penalty

Initial $765.00 · Current $615.00 Reduced

General-duty citation text

29 CFR 1904.29(b)(6): Employee(s) names were not removed from the OSHA 300 Log when employee(s) experienced privacy concern cases:    Broomfield Skilled Nursing & Rehabilitation Center LLC, at 12975 Sheridan Boulevard, Broomfield, CO:  On and preceding 2/26/13, Broomfield Skilled Nursing & Rehabilitation Center LLC did not ensure that employees names were removed from the OSHA 300 Log when employees experienced privacy concern cases.  Two employees involved in privacy concern cases in 2010 did not have their names removed from the 2010 OSHA 300 Log.

Issued

2013-08-23 00:00:00

Abate by

2013-09-27 00:00:00

Penalty

Initial $0.00 · Current $0.00

General-duty citation text

29 CFR 1910.132(d)(2): The employer did not verify that the required workplace hazard assessment had been performed through a written certification which included the requirements as outlined in 29 CFR 1910.132(d):    Broomfield Skilled Nursing & Rehabilitation Center LLC, at 12975 Sheridan Boulevard, Broomfield, CO:  On and preceding 2/26/13, Broomfield Skilled Nursing & Rehabilitation Center LLC did not verify that the required workplace hazard assessment had been performed through a written certification which included the requirements as outlined in 29 CFR 1910.132(d).  Employees were exposed to toxic chemicals, chemical splashes, and flying objects during maintenance, housekeeping, and kitchen duties at a skilled nursing facility.  The employer had not certified that a personal protective equipment hazard assessment had been performed.  Employees were exposed to the following, but not limited to, hazards:    1.  Exposure to spraypaint, wood dust, and other dust while performing maintenance duties;  2.  Exposure to EcoLab 146 Multi-Quat Sanitizer, EcoLab Oasis Greasecutter Plus (containing 4% sodium hydroxide), and US Foods Pure Bright Disinfectant (containing 5% sodium hypochlorite) when performing kitchen duties;  3.  Exposure to EcoLab Laundri Destainer (containing 8.4% sodium hypochlorite), EcoLab Oasis 299, EcoLab Oasis 499, and EcoLab Lavender Paradise when performing laundry duties; and  4.  Exposure to EcoLab 146 Multi-Quat Sanitizer when performing housekeeping duties.

Issued

2013-08-23 00:00:00

Abate by

2013-09-27 00:00:00

Penalty

Initial $0.00 · Current $0.00

General-duty citation text

29 CFR 1910.134(k)(6): The employer did not provide the basic advisory information on respirators, as presented in Appendix D of this section, in any written or oral format to employees who wear respirators when such use is not required by this section or by the employer:    Broomfield Skilled Nursing & Rehabilitation Center LLC, at 12975 Sheridan Boulevard, Broomfield, CO:  On and preceding 2/26/13, Broomfield Skilled Nursing & Rehabilitation Center LLC did not provide the basic advisory information on respirators, as presented in Appendix D of this section, in any written or oral format to employees who wear respirators when such use is not required by this section or by the employer.  The employer allowed maintenance employees to voluntarily wear N95 filtering facepiece respirators when spraypainting, cutting wood, or when exposed to dust.  The employer did not provide the basic advisory information as presented in Appendix D.  This condition potentially exposed employees to a respiratory hazard.