OSHA Inspection: WOODLANDS SENIOR LIVING OF BREWER, LLC

Issued

Jul 8, 2016

Abate by

Jul 27, 2016

Penalty

Initial $7,000 · Current $0 Reduced

General-duty citation text

OSH ACT of 1970 Section (5)(a)(1): 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 required to perform tasks resulting in physical stressors that have caused or were likely to cause musculoskeletal disorders (MSDs):    Establishment - Personal Care Attendants, Certified Residential Medical Aides, and Housekeepers manually lift, transfer, and reposition non-weight bearing and partial weight bearing residents, exposing them to tasks, such as but not limited to transfers to and from the wheelchair, resulting in injuries.    Feasible and useful method to correct the hazard - Fully implementing a comprehensive Safe Patient Handling Program which includes a lifting and transferring policy and related procedures with guidance on the reduction and/or the elimination of manual resident handling tasks by increasing the use of appropriate equipment and mechanical devices, improving the methods for assessing the needs of each non-weight bearing  resident, and partial and full weight bearing resident to determine the safest method to lift, transfer, ambulate or reposition each resident by the staff.  The program should include:  1.  Resident Assessment:  The facility should continue to assess the following: a) Lifting, transferring, and repositioning needs of each resident and b) Safety consideration for direct care employees by selecting the most appropriate assistive devices based on the residents? ability to bear weight, follow directions, assist with bed mobility, ability to ambulate, and the rehabilitation goals.   The resident assessment will eliminate all manual physical assists by three persons and minimize in all cases and eliminate when feasible the manual physical assist by one or two persons to lift, transfer and reposition the resident.   An assessment criteria should be used to determine a resident?s movement needs and identify the most appropriate methods to move and ambulate the resident while minimizing in all cases and eliminating when feasible the manual physical assistance required by the staff.  The assessment should take into consideration the NIOSH recommended weight limit of 35 pounds for resident handlers.   The facility should continue to convey to all staff responsible for the resident care through formal shift change meetings, care plan documentation, and training with the mind set of keeping the resident as independent as possible but at the same time addressing the actions that may cause resident handler injury.  2.  Equipment: A sufficient amount of appropriate assistive devices will be provided with the variety of appropriate slings for the tasks to enable mechanical lift, transfer, ambulation and repositioning for the residents and protect the staff. The employer should provide several demonstration models for staff as a trial basis prior to purchase. The number of lifts to ensure staff safety depends on the residents? physical dependency.   In order to eliminate manual lifting more than 35 pounds of the resident?s body weight the following should be considered: a) One full dependency lift is needed for every 8 to 10 non-weight bearing residents; b) One sit/stand lift should be provided for every 8 to 10 partial weight bearing residents; c¬) Ambulation aids are needed for every resident with balance, strength or endurance limitations; and d) Repositioning devices with friction?reducing aids or slip sheets should be available to assist with any repositioning needs to eliminate manually lifting more than 35 pounds of the resident?s body weight.  The equipment footprint will be considered for the bedroom and bathroom configurations.  3.  Workplace Assessment:  The resident?s rooms, bathrooms, bathing areas and floor transitions should be assessed to identify factors that might contribute to resident handling incidents. This includes bedroom space constraints, furniture that might interfere with transfers or repositioning, the bathroom configuration, the shower room constraints, the distance from the resident?s room or dining room to the shower/toilet room, bed height adjustability, kitchen, the equipment storage locations and other physical barriers that might restrict movement of lifting equipment.  4.  Training: Training will be provided to all staff on all shifts responsible for implementing the comprehensive system-wide approach to safe resident handling which includes administrators, nursing staff, maintenance staff and the direct care providers to include the concept that resident handling will minimize in all cases, and eliminate when feasible, the manual physical assist by one or two persons to lift, transfer and reposition the resident.  The staff will be trained and demonstrate competence in the equipment and device use and procedures to follow for resident lifting, transferring, repositioning, and ambulating equipment.  5.  Staff Responsibilities:  ? Administrator will ensure the following: a) Continuing support and understanding of  the implementation of the new Ergonomics Program policies and procedures; b) All staff affected by the policy are trained by providing appropriate and sufficient assistive devices for all the resident handling tasks in the facility; c) Identifying acceptable storage locations for the resident handling equipment; d) Providing the resources necessary for the medical management program and resident handling program; e) Assign safety and health responsibilities to hold subordinates accountable; and f) The safety and health program remains effective and open to improvements  ? Supervisory Personnel/Program Coordinators will ensure the following: a) Increase additional training in hazard detection and accident/incident investigation; b) Ensure maintenance controls and availability of assistive devices; and c) Reinforce employee training through continual performance feedback and through enforcement of safe work practices ? Assessment Team will provide the appropriate assessment of each resident to determine lifting and transferring methods that are consistent with the resident?s needs and rehabilitation goals that minimize in all cases (eliminate when feasible) the manual assist by one or two persons to lift, transfer and reposition the resident.  All residents will be quickly reassessed if their condition changes.     ? Direct Care Providers (PCAs/CRMAs) will be provided with the following: a) Training to become competent in the procedures when transferring or moving the residents; b) Training to use appropriate assistive devices when performing high-risk resident handling tasks; c) Ability to report any resident handling injury to management without any barriers or reprisal; and d) The ability to continue to notify management without any barriers or reprisal of the following: (1) Change in resident?s condition; (2) The need for retraining on devices or equipment; and (3) Immediately notify maintenance or a designated member of management for immediate response to repair or replace mechanical devices, slings, or missing components 6.  Medical Management Program   The program will include the following elements such as, but limited to:  a) All injuries should be reported promptly to the unit manager without any barriers or reprisal; b) Each injury should be promptly investigated to determine the root cause, address the findings, develop and implement preventive measures; and c) Ensure that musculoskeletal disorder injuries which have occurred are tracked and trended on a regular basis using data from the past three years in order to improve upon the Ergonomics Program through education, training, and monitoring the needs for additional assistive devices.

Issued

Jul 8, 2016

Abate by

Jul 18, 2016

Penalty

Initial $1,000 · Current $0 Reduced

General-duty citation text

29 CFR 1904.4(a): The employer did not record each work-related fatality, injury or illness case that resulted in the general recording criteria on the OSHA Form 300 or equivalent:  Brewer Facility -  The employer did not record the 01/15 - right hand tingling, numbness injury on the OSHA Form 300 or equivalent for the calendar year 2016.