On June 25, 2015, the Occupational Safety and Health Administration (OSHA) released a memorandum, entitled "Inspection Guidance for Inpatient Healthcare Settings," establishing new guidance for OSHA staff for inspections conducted in inpatient healthcare settings nationwide. The guidance applies to all Federal OSHA inspections, programmed and un-programmed, conducted in hospitals and nursing and residential care facilities; and calls for the investigation of the potential for or existence of hazards.

The goal of the new guidelines is to significantly reduce overexposures to these hazards through a combination of enforcement, compliance assistance, and outreach. Hospitals and nursing homes will now be subject to stricter and broader inspections by OSHA.

Inpatient healthcare settings have some of the highest rates of injury and illness among industries nationwide. Hospitals, for instance, have the highest number of nonfatal occupational injuries reported for all private industries. Much of the new OSHA guidelines focus on musculoskeletal disorders (MSDs), as injuries attributed to overexertion-related incidents account for almost half of all reported injuries in the healthcare industry, making MSDs nearly a third of all reported injuries for all industries.

The new guidelines charge OSHA inspectors with the review of certain focus hazards including MSDs relating to patient or resident handling, workplace violence, blood borne pathogens, tuberculosis and slips, trips and falls. This policy replaces a previous directive CPL 03-00-016, National Emphasis Program – Nursing and Residential Care Facilities, which established a National Emphasis Program (NEP) to reduce occupational illness and injury in nursing and residential care facilities with specific emphasis on many of the same hazards addressed in the new policy. The new policy expands OSHA's enforcement and other resources to include inspections of inpatient healthcare facilities, including hospitals and nursing homes, as well as broadening inspections of those hazards and others.

The policy dictates that compliance officers are required to:

• Perform partial walkthroughs and interview workers to verify injury and illness records
• Assess incidence and severity rates and determine whether the facility has implemented a process to address any potential or existent hazards
• Send alert letters, other communication or issue citations when issues are identified

The new guidelines require not only that facilities have modalities in place to comply with the new inspection guidelines, but also that State Plans code their own inspections to meet the new OSHA policy. While this means existing Local, Regional and State Plans must meet the standards expressed in the new guidelines, it does not force states to enact State Emphasis Programs (SEP) where they do not already exist. Any SEPs, would however, have to comply with the guidance provided in the new policy, whether existing or new.

In addition, the guidance expands the scope of inspections where other hazards come to the attention of compliance officers. OSHA staff are expected to investigate where it is determined that employees are not protected from other hazards, including exposure to multi-drug resistant organisms, such as Methicillin-resistant Staphylococcus aureus (MRSA) and exposures to hazardous chemicals, such as sanitizers, disinfectants, anesthetic gases and hazardous drugs.