Recently some facilities have been finding out the hard way that in addition to all of the other COVID-19 reporting requirements, certain employee COVID-19 cases must also be reported to OSHA.  According to the Ohio Health Care Association (OHCA) presentation “Preparing for OSHA Inspections Related to COVID-19”, OSHA has been monitoring the employee cases being reported by facilities to the NHSN/CDC site.

Reporting COVID-19 to OSHA

OSHA is looking for these COVID-19 reported areas:  1) employee deaths, and 2) employee hospitalizations.  If they find employee COVID related deaths that were not reported to OSHA within the required 8 hours, or employee COVID related hospitalizations that were not reported within the required 24 hours, they have been completing on-site OSHA inspections of facilities in some cases.

OSHA defines “work-related” COVID-cases as follows:

 You must consider an injury or illness to be work-related if an event or exposure in the work environment either causes or contributed to the resulting condition or significantly aggravated a pre-existing injury or illness.  Work-relatedness is presumed for injuries or illnesses resulting from events or exposure occurring in the work environment.

While OSHA does not expect employers to perform “extensive medical inquiries”, they do expect proof of “sufficient effort,” and they provide guidelines for completing the investigation and determining whether or not the employee’s COVID infection is work-related.

Other Requirements

In addition to the reporting obligation, OSHA also has several other COVID specific requirements, with one of the most important involving documentation.  Under OSHA’s recordkeeping requirements, COVID-19 is a recordable respiratory illness on the OSHA form 300, and employers are responsible for recording cases of COVID-19 if: (1)  the case is a confirmed case of COVID-19, as defined by the CDC; (2) the case is work-related as defined by OSHA 1904.5; and (3)  the case involves one or more of the general recording criteria set forth in OSHA 1904.7.  It is important to note that these criteria include days away from work and restricted work activity.

As reported in the OHCA presentation, there are 3 critical areas that facilities are seeing cited during the on-site OSHA COVID related inspections. Notably, each involves a lack of documentation.  These areas include a failure to have:

      • A written respiratory protection program with worksite specific procedures for the use of respirators.
      • Documentation of a medical evaluation (by a physician or other qualified licensed health care professional) to determine the employee’s ability to use a respirator before they are fit tested or required to use a respirator.
      • Documentation of fit testing completed before an employee may be required to use any respirator, such as an N95 or similar negative or positive pressure tight-fitting face piece.

While OSHA has acknowledged that there continues to be a national shortage of respirators and other PPE, they are reported to be citing facilities for the lack of documentation in the other required areas.  They are also looking for documentation on the efforts made by the facility to acquire the needed PPE, and to provide the required fit-testing.

If you find that your facility is not fully compliant with all of the OSHA COVID requirements, now is the time to get the necessary components in place.  Should failure to report a death or hospitalization be one of the areas that has not been completed, it is recommended you reach out to your facility legal counsel for guidance on how to proceed to address this.

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Blog by Janine Lehman, RN, RAC-CT, CLNC, Proactive Medical Review

Learn more about Janine and the rest of the Proactive team.