Worker Safety & Health in the Nursing Home Industry
Scope of the Problem
The nursing home industry is one of America's fastest growing
industries. Today nursing homes and personal care facilities employ
approximately 1.6 million workers at 21,000 work sites. By the year
2005, industry employment levels will rise to an estimated 2.4
million workers.
According to the Bureau of Labor Statistics, in 1994 nursing and
personal care facilities reported 221,200 nonfatal occupational
injuries and illnesses to their personnel. Among U.S. industries
with 100,000 or more nonfatal injury or illness cases, nursing
homes have the third highest rate--16.8 injuries and illnesses per
100 full-time workers. Only meat products processing (at 26.5)
and motor vehicle/equipment manufacturing (at 25.4) have higher
incidence rates.
Nursing home workers suffer most injuries (51.2 percent) when
handling residents. Fifty-eight percent of their injuries are strains
and sprains. While back injuries account for 27 percent of all
injuries in the private sector, in nursing homes they account for
42 percent of all injuries. Of the 10 occupations with the largest
number of injuries illnesses, nursing aides and orderlies are
exceeded only by truck drivers and nonconstruction laborers.
OSHA's Emphasis on Nursing Homes
The Occupational Safety and Health Administration is beginning
an outreach and enforcement initiative aimed at reducing injuries
and illnesses among nursing home workers. This initiative
emphasizes taking a comprehensive safety and health program
approach to address all safety and health hazards and all
causes of injuries and illnesses in the industry.
Seven states, each with more than 500 nursing homes, have
been chosen to be part of OSHA's pilot program in the
nursing home industry:
Florida New York
Illinois Ohio, and
Massachusetts Pennsylvania
Missouri
Outreach
To prepare for this pilot program, OSHA compliance officers
have been specifically trained in the characteristics of the nursing
home industry, in other regulations that apply to the industry,
safety and health programs, the financial benefits of safety and
health programs, and hazard recognition and control, including
how to handle residents safely.
In September, OSHA will offer free training and education
seminars to nursing home industry representatives in each of
the seven targeted states. The training will key, among other
things, on:
- how to develop a safety and health program appropriate
for a nursing home;
- how to identify and prevent specific injuries and illnesses
associated with bloodborne pathogens, tuberculosis, and
resident handling injuries; and
- ideas for preventing workplace violence.
Additionally, small nursing home employers can take advantage
of OSHA's free consultation services, available in every state.
Trained experts can help employers identify and correct specific
hazards and implement comprehensive safety and health programs.
This service is provided to employers with the assurance that their
names and any information about their firms will not be routinely
reported to OSHA.
Enforcement
OSHA will use a common-sense approach for enforcement in
the nursing home industry. The agency will target work sites
with the greatest documented safety and health problems and
will use tools such as the phone/fax method for handling safety
and health complaints.
Safety Pays Off in Nursing Homes
Many nursing home employers already have learned that
working safely is good way to not only help protect their
employees, but also affect the bottom line. When one nursing
home employer in implemented a program to address safe resident
handling, his worker's compensation premium dropped from
$750,000 to $184,000. A similar resident handling program at
another nursing home in led to a striking reduction in lost
workdays --from 2,200 in 1993 to only 31 in 1996.