Author Archive for: Steven Porter

Second ‘immediate jeopardy’ status lifted, still falling short

October 4th, 2017 Email This Post Print This Post

After a follow-up visit by state surveyors late last month, a Missouri hospital has had its second “immediate jeopardy” finding this year lifted. But the facility remains out of compliance.

Mercy Hospital Springfield retains its CMS certification despite continuing to fall short of the Conditions of Participation (CoP) pertaining to nursing services and patient rights, a spokesperson for the CMS regional office in Kansas City said this week. Surveyors will return to the facility once again this month to determine whether the hospital has brought its operation into compliance with the CoPs, the spokesperson said.

In January, surveyors faulted the hospital’s Behavioral Health Unit (BHU) for failing to properly handle certain tense situations, including one incident that involved a scuffle between a nurse and a patient diagnosed with schizoaffective disorder. That survey resulted in an immediate jeopardy finding, but the status was removed when the hospital provided an immediate action plan to remedy the situation. The BHU worker involved in the scuffle was placed on administrative leave in January, then his employment was terminated in February.

In April, a follow-up visit determined that the hospital’s condition-level deficiencies had been corrected, though there were still standard-level citations pertaining to patient rights, according to records obtained via state and federal public records requests.

In August, the hospital was found in immediate jeopardy once again and given less than a month to address its problems or lose Medicare funding. The facility fired 12 workers, implemented new and additional training modules, and brought in an interim leadership team before surveyors returned for their follow-up visit.

One former nurse in Mercy’s Emergency Department (ED) wrote an opinion piece for the Springfield News-Leader defending the fired workers. David Schneider, a traveling nurse, argued that ED staff are subjected to verbal and physical threats and abuse on a daily basis, adding to the difficulty of their jobs.

“Health care staff in Springfield are being abused by members of the community on a daily basis and as the result of the employee terminations at Mercy … many of those health care members now feel more unsafe,” Schneider wrote.

Additional detail on the Statement of Deficiencies and Plan of Correction stemming from the August inspection are not yet publicly releasable but should be available soon, the CMS spokesperson said.

A hospital spokesperson didn’t respond to my request for comment this week, but the News-Leader reported that the hospital released a statement Friday announcing that the immediate jeopardy had been lifted. Jon Swope, interim president of Mercy Springfield Communities, thanked the hospital’s stakeholders for their input and hard work in implementing a variety of changes.

“I’m certain Mercy Hospital Springfield will be even better because of these efforts,” Swope said in the statement, as the News-Leader reported. “We are empowering our co-workers with additional skills and resources so they may fully cherish the dignity of every individual we serve.”

Fact sheet unveiled to protect lab workers from Zika virus

October 3rd, 2017 Email This Post Print This Post

A new OSHA Fact Sheet has been published to help employers protect biomedical laboratory workers from the Zika virus, which has been blamed for infants being born with Microcephaly and other brain and eye abnormalities.

For lab workers, the most likely sources of exposure to Zika include needlesticks and similar cuts or puncture wounds, as well as areas of compromised skin that come into contact with contaminated materials, according to the four-page fact sheet. Workers also face risks of exposure through the eyes, nose, and mouth; mosquito bites; and coming into contact with blood or other body fluids.

“Employers and workers in laboratories should follow required and recommended infection prevention and biosafety practices to minimize the risk of infection,” the document states, noting that employers must comply with relevant regulations and standards, such as OSHA’s Bloodborne Pathogens standard.

“In all cases, employers should assess and control their workers’ Zika virus exposure risk, consider relevant advisory documents, and review new information as it becomes available, including from the Centers for Disease Control and Prevention (CDC),” the document states.

For more, download the fact sheet from OSHA’s website.

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List of OSHA standards cited most frequently in 2017 released

September 28th, 2017 Email This Post Print This Post

Fall protection training requirement makes debut on annual top 10 list

The annual list of most-frequently cited OSHA standards was released this week at the National Safety Center (NSC) Congress & Expo in Indianapolis. Although the list looks pretty similar to years past, there has been some movement.

The general requirements of fall protection (1926.501) ranked first on the list again this year, as it did last year and the year before that. The top five categories, in fact, have held their positions for the past three years.

The hazard communication requirements (1910.1200)—which are especially pertinent to healthcare employers and other industries where workers handle hazardous substances—have held steady as the second-most-frequently cited set of OSHA standards.

Citations related to electrical wiring (1910.305) have continued their downward trend relative to the other top standards, moving from eighth place to 10th in two years. This year’s ninth-place finisher, fall protection training requirements (1926.503), jumped onto the list for the first time in recent memory.

For more detail on the OSHA standards for the past three years, review the chart below. (Or click here for the PDF version.) The numbers associated with each category indicate the number of violations cited under each set of standards. These numbers are based on each fiscal year, and they are considered preliminary. A final report will be published in the December edition of NSC’s Safety+Health magazine.

NSC President and CEO Deborah A.P. Hersman said in a statement that the list of top OSHA violations is “a blueprint for keeping workers safe.”

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Deadline suspended for Missouri hospital facing second ‘immediate jeopardy’ finding this year

September 27th, 2017 Email This Post Print This Post

A hospital in Missouri had been given until September 22 to bring its operation into compliance with the CMS Conditions of Participation (CoP) after surveyors last month found significant problems pertaining to nursing services and patient rights. That deadline has been suspended, however, as federal regulators review the findings of a follow-up visit.

State surveyors returned last week to Mercy Hospital Springfield to determine whether the facility has fixed the problems that led to the “immediate jeopardy” findings in August, a spokesperson for the CMS regional office in Kansas City said this week. Suspending the deadline gives CMS time to review what the follow-up surveyors found, the spokesperson said.

In early September, the hospital announced that it had recently fired 12 employees after determining that their behavior in “highly tense situations” had been inadequate. Remaining staff members would receive additional training on de-escalation techniques and preventing patient abuse and neglect, the hospital said. The following week, an interim leadership team stepped in.

“Everything we’re doing is to ensure the well-being and safety of everyone, including our co-workers,” hospital spokesperson Sonya Kullmann said.

Details from the August inspection are not yet publicly available, but records obtained via the Missouri Sunshine Law and the federal Freedom of Information Act indicate that Mercy Hospital Springfield has struggled recently to recognize incidents of possible abuse and neglect. The Missouri Department of Health and Senior Services and CMS each released the findings of a complaint investigation conducted in early January and the hospital’s subsequent plan of correction. (To review the 219 pages of records released by the state, download the PDF.)

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Missouri hospital in ‘immediate jeopardy’ fires 12 workers, installs interim leadership team

September 13th, 2017 Email This Post Print This Post

Corrective steps being taken to protect patients and workers alike, hospital says

A hospital in Missouri at risk of losing its Medicare funding within the month installed an interim leadership team this week as it seeks to appease federal inspectors.

Mercy Hospital Springfield was placed in “immediate jeopardy” by CMS after an inspection last month found significant violations of the regulations pertaining to nursing services and patient rights. The hospital announced last week that it had fired 12 employees whose behavior in “highly tense situations” was deemed inadequate. That news was followed Tuesday by an announcement that the interim leaders would step in to right the ship.

“They bring a fresh perspective and will help bolster local resources,” said Jon Swope, interim president of Mercy Springfield Communities, in a statement announcing six temporary leaders.

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Bipartisan bill passes Senate Appropriations Committee, could preserve OSHA funding

September 8th, 2017 Email This Post Print This Post

Democrats and Republicans on the Senate Appropriations Committee came together this week to pass a budget plan that would keep federal OSHA funding at the same level in fiscal year (FY) 2018 as is today.

The bill, which addresses spending by Labor, HHS, Education and related agencies, calls for the Labor Department to be funded by $12 billion overall—that’s a slight cut of $61.5 million or about 0.5% from the funding level in FY 2017—according to a summary released by the committee’s Republican members. It passed by a vote of 29-2.

“For the second year in a row, the committee has worked together in a tough fiscal environment to pass a bipartisan bill that reflects Americans’ priorities,” said Sen. Roy Blunt (R-Mo.), chairperson for the subcommittee on Labor and HHS appropriations, in a statement.

Sen. Patty Murray (D-Wash.), ranking member of the subcommittee on Labor, HHS, Education, and related agencies, said in a separate statement that she’s pleased to see bipartisanship at work, though there’s more to be done.

“While I support this bill as a compromise and the best we can do given the inadequate investment levels we’ve been given, it underscores the need for us to keep working toward another budget deal to increase investments in people, communities, and economic growth,” Murray said. “But this bill is a good first step and a strong foundation for continued bipartisan work.”

Labor agencies would fare far better under this Senate appropriations bill than the version under consideration by the House, which proposed even deeper cuts for OSHA’s enforcement budget than President Trump had requested, as Bloomberg BNA’s Bruce Rolfsen reported in July.

Jordan Barab, a former OSHA official and an outspoken critic of the Trump administration, said a flat budget (i.e., no increase in funding) could be the best-case scenario “considering who controls the White House and Congress.”

“Although we’ll end up with strikingly different bills in the Senate and the House, the expectation is that, because the Senate bill is a bi-partisan measure that both parties have agreed on, the current funding is likely to be maintained if there is a final bill,” Barab wrote on his blog, Confined Space. If, he added, Congress were to resort to a continuing resolution rather than passing a final bill, that too would keep funding at about the same levels as they stand today.

California hospital where worker was murdered still an example of violence plaguing healthcare

August 31st, 2017 Email This Post Print This Post

Six years after a psychiatric technician at Napa State Hospital was murdered by a patient, regulators within the California Division of Occupational Safety and Health (Cal/OSHA) approved a new rule last fall to protect healthcare workers from on-the-job violence.

The rule took effect in April, and I covered the story in our May edition of Briefings on Hospital Safety, noting that federal OSHA officials were asking whether drafting a similar nationwide standard would be appropriate and worthwhile. Since then, the Trump administration has pared back OSHA’s regulatory agenda and classified the initiative to prevent workplace violence in healthcare settings as among the agency’s “long-term actions,” with no date set for the initiative’s next action item.

Meanwhile, the workers at Napa State Hospital continue to report frequent assaults against employees and patients alike. Cal/OSHA is investigating an attack on May 9, 2017, that left one worker with serious bodily injuries, the Napa Valley Register reported this month. Officials did not specify the circumstances of the attack, but a 26-year-old man arrested the following day had reportedly punched a staff member multiple times in the head and face, with a closed fist, before lifting a medical table above his head in an effort to use it as a weapon against the worker.

A judge ordered the hospital to release unredacted documents about the incident to Cal/OSHA after complaints that previously released documents “were so heavily redacted that they provided no meaningful information” to state investigators, the Register reported.

There were 886 assaults on staff reported at Napa State Hospital in 2015, according to the California Department of State Hospitals violence report for 2016. That figure was about the same in 2014 and 2013, but it was higher in 2012, when 1,048 assaults on staff were reported.

The 886 assaults on staff in 2015 are in addition to the 1,053 reported assaults on patients.

“That’s 1,939 reported assaults and who knows what wasn’t reported,” Michael Bartos, MD, former medical chief of staff for Napa State Hospital, wrote in a letter to the Register editor last week.

“A facility with 1,200 patients that reports over 1,000 patient assaults in a single year could be considered somewhat less than a healing environment and with almost 900 staff assaults might not be the best place to work, even with generous state benefits,” Bartos added. “Despite the problems, the majority of front line staff including nurses, psychiatry technicians, social workers, rehabilitation therapists, psychologists and psychiatrists, are dedicated professionals doing their best under difficult circumstances.”

OSHA buries worker fatalities list

August 25th, 2017 Email This Post Print This Post

What had been featured prominently on the agency’s homepage is now shorter and harder to find

Earlier this week, if you had navigated to OSHA.gov in search of information about the U.S. Department of Labor’s (DOL) agency committed to improving the safety of American workers, you would have been greeted by a prominent ticker listing recent workplace fatalities. Each entry had a date, state, name, and brief explanation of how the worker died.

That item was removed Friday from the OSHA website, however, in an effort to make the public data more “accurate and useful,” Politico reported, citing a DOL spokesperson.

“The previous listings included fatal incidents that were outside federal OSHA jurisdiction, not work-related, or the employer was not cited for a violation related to the incident,” Mandy Kraft said in a release. “We are continuing to review all of the data to ensure it is accurate and useful to our stakeholders.”

Critics were quick to blast the change. Jordan Barab, a former OSHA official under the Obama administration, called it a “brazen attempt to hide from the American public the extent of workplace fatalities in this country.”

In place of the workplace fatalities ticker, the updated OSHA site now lists information on training, compliance assistance, and cooperative and recognition programs. Then there’s an introduction to a new ticker praising specific companies by name: “Below are just a few examples of our cooperative programs that work with and recognize employers who create safe workplaces,” it says.

“This list will soon get pretty stale,” Barab wrote. “There are a lot more workers killed on the job every month than new VPP, SHARP or Alliance participants in an entire year.”

Representatives with DOL and OSHA did not immediately respond Friday to requests for comment.

Update (8/28/17): An OSHA spokesperson responded in an email Friday with the same comments reported by Politico. “Previous entries [in OSHA’s fatalities data set] remain available in the original format on OSHA’s data and statistics page,” the spokesperson noted. The Wall Street Journal reported Sunday that the U.S. Chamber of Commerce had asked OSHA to revise its fatalities-reporting practices.

Potential security breach prompts suspension of OSHA’s new injury-tracking portal [UPDATED]

August 17th, 2017 Email This Post Print This Post

[Editor’s note: Access to OSHA’s data portal has been restored. See updates below.]

Just two weeks after its already-delayed launch, an online portal designed to collect data on worksite injuries has been suspended amid information security concerns.

Use of the portal, OSHA’s Injury Tracking Application (ITA), was supposed to become mandatory for certain employers on July 1, 2017, pursuant to the controversial electronic recordkeeping rule. But officials signaled back in May that they would be postponing the deadline, and they formally did so in June—giving the approximately 466,000 affected employers five additional months, until December, to begin using the application.

The ITA finally went live August 1, a full month after its original implementation date, as labor attorney Tressi L. Cordaro with Jackson Lewis P.C. noted Monday in a blog post. The ITA was suspended, however, on Tuesday after the Department of Homeland Security (DHS) notified the Department of Labor (DOL) that user information might have been compromised, Cordaro added Wednesday.

Those who tried accessing the portal Thursday morning were greeted with a message in red lettering: “Alert: Due to technical difficulties with the website, some pages are temporarily unavailable. To file a complaint with OSHA or to ask a safety and health question, call 1-800-321-6742 (OSHA).”

Bloomberg BNA’s Ben Penn reported Wednesday that a DOL official didn’t identify the one company involved in the potential breach. While the portal will eventually be used to collect detailed employee records, experts told Penn that the information currently being collected isn’t sensitive. That being said, the snafu could betray a level of unpreparedness in the ITA rollout.

“This agency has a lot of experience with doing this—and doing it right,” said Deborah Berkowitz, a senior fellow with the National Employment Law Project who served as OSHA chief of staff under former President Barack Obama, according to Penn’s report. “This is a brand new application, and because of the new administration, it was never tested.”

Berkowitz added that OSHA should take the time offered by this suspension to “get it right” and protect the database.

Representatives with DOL and OSHA contacted via email and telephone were not immediately available Thursday to answer questions about the suspension and possible breach.

Update (8/25/17): The application was back online as of Friday, August 25, 2017. I have requested additional details on what led to the outage and will publish what I find.

Update (8/28/17): An OSHA spokesperson said in an email that the National Information Technology Center conducted a scan and confirmed that none of the ITA data had been compromised. “As part of this review, the entire OSHA website was scanned and improvements implemented,” the spokesperson said. Public access to the portal was restored Friday, as OSHA continues its regular security monitoring processes.

Treatment center slapped with $207k proposed fine as OSHA announcements grow rarer

August 16th, 2017 Email This Post Print This Post

Facility accused of failing to address workplace violence risks it had promised to remedy

A psychiatric treatment center in Massachusetts faces more than $207,000 in proposed penalties after OSHA accused the facility of failing to adequately protect employees from workplace violence, despite having promised specifically to do so.

Notice of the proposed action against Lowell Treatment Center, which is operated by UHS of Westwood Pembroke Inc., comes as OSHA has grown significantly quieter about its enforcement activity under President Donald Trump’s administration than it had been under former President Barack Obama. There have been fewer enforcement-related OSHA press releases issued in the seven months since Trump took office than there were in just the final month of 2016.

It remains unclear how OSHA decides which enforcement actions warrant a press release. An agency spokesperson was not immediately able Wednesday to answer questions about this threshold. But we know that this case entails allegations that the facility failed to keep specific promises it made last year in a formal settlement agreement stemming from an unfavorable 2015 evaluation by federal inspectors.

“Our inspectors found that employees throughout the Lowell Treatment Center continued to be exposed to incidents of workplace violence that could have been greatly reduced had the employer fully implemented the settlement agreement,” OSHA’s Boston-based regional administrator Galen Blanton said last week in a written statement.

The management company, which operates 350 facilities throughout the United States and United Kingdom, notified OSHA that it intends to contest the findings, according to the press release.

Micah Smith, an OSHA attorney with Conn Maciel Carey in Washington, D.C., said during a webinar Tuesday that the Obama administration had engaged in “regulation by shaming.” And any Republican in the White House would be expected to back off of Obama-era levels of enforcement, he said.

“We’re expecting to see this change, and that press-heavy enforcement model to be rolled back,” Smith said. “We haven’t seen any official actions, but in the early days of the administration, most agencies across the government have been encouraged or required to reduce their press activity.”

Smith said there were two or three OSHA enforcement press releases in June and July this year, compared to 25-40 for each of the same months last year. Even so, it’s important to note that OSHA’s priorities are just as unsettled as its staffing.

“As with all things, without the permanent OSHA team in place, we’re still reading the tea leaves a little bit,” Smith said.

The press release in this case comes two months after OSHA endured criticism for backing off an allegation that Bergen Regional Medical Center (BRMC) in Paramus, New Jersey, had an inadequate workplace violence prevention plan. Jordan Barab, a former OSHA official under Obama, drafted a lengthy blog post critical of the move, and he clashed on Twitter with Eric Conn, another attorney with Conn Maciel Carey, who was hired to represent BRMC’s defense against the citation.

Barab, who has also been critical of the marked decrease in the issuance of OSHA enforcement press releases, hasn’t blogged since OSHA issued its press release last week.

Update (8/23/17): Barab blogged yesterday about this case. “Although I am frequently critical of OSHA under the Trump administration,” he wrote, “never let it be said that I have failed to praise the agency when they do something good.”

Bizarre circumstances led to hospital’s hazmat response, ER lockdown

August 2nd, 2017 Email This Post Print This Post

Report: Suspicious package that prompted mini-emergency was letter from government agency

If you subscribe to HCPro’s monthly Briefings on Hospital Safety newsletter, you will recall the story of a hazardous material scare and emergency lockdown at Frederick Memorial Hospital in Maryland. Two men opened a piece of mail at home in May, discovered a suspicious substance inside, and began experiencing skin and respiratory irritation, so they went to the local ED—and brought the unknown substance with them. That, of course, sent hospital staff scurrying to contain the threat.

Because the men live across the street from the U.S. Army’s Fort Detrick, a hub for biodefense research, there was added concern that the substance might be a biological agent. That turned out not to be the case. Investigators quickly identified the substance as a relatively common household chemical. But the circumstances leading up to that hazmat scare and lockdown, as reported in the local newspaper, are still baffling.

The substance that caused the hubbub was ultimately determined to be an ingredient found in rat poisoning, The Frederick News-Post’s Jeremy Arias reported last week. That substance was delivered in an envelope from the National Institute of Standards and Technology (NIST) in Gaithersburg, Maryland, to the home address of Jay Zimmerman, who said he had held a position with NIST for 33 years. The envelope also reportedly contained a letter from NIST informing Zimmerman that he would be removed from his position.

Zimmerman, who retired from NIST in June, told the News-Post that he believes his former employer used the substance to target him as an act of retaliation because Zimmerman had filed a complaint against NIST earlier this year alleging discrimination and harassment on account of his sexual orientation and disability. A spokesperson for NIST declined to comment on the allegations, citing the Privacy Act.

Investigators reviewed surveillance footage at NIST that shows the suspicious package being sealed, Frederick police Sgt. Andrew Alcorn told the News-Post.

“There is nothing on the video that appears to be suspicious or that indicates any of that substance was put into the package at that point,” Alcorn said.

Although the case was officially suspended without any charges being filed, the resulting response gave Frederick Memorial an opportunity to test its own emergency preparedness.

“When events like this take place,” said Phil Giuliano, the hospital’s director of public safety and security, “I think it’s a reminder for hospital staff, hospital leaders, and community members as a whole how important it is to have strong relationships, to maintain strong relationships with those other partners you have in your county, in your jurisdiction, in your area of operations.”

For more on this story and how Frederick Memorial kept its workers and patients safe, be sure to read the News-Post’s full report and the August edition of Briefings on Hospital Safety.

Spruced-up online OSHA form aims to help whistleblowers

July 28th, 2017 Email This Post Print This Post

A revised online form backed by OSHA aims to make it easier for whistleblowers to complain about their employers, the U.S. Department of Labor (DOL) announced Friday.

Workers still have a right to lodge formal complaints in a number of other ways: snail mail, fax, hand-delivery, verbally on the phone or in person. But the updated web-based filing option offers an interactive option available all day every day, designed help workers navigate the potentially daunting seascape of laws and regulations that keep worker rights afloat.

The whistleblower provisions of some 22 statutes are enforced by OSHA, affecting everything from workplace health and safety to consumer protection and nuclear power. (Details on that are available at www.whistleblowers.gov.)

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