The Occupational Safety and Health Administration ("OSHA") recently announced a three-year enforcement effort, focused on ergonomic issues in nursing and residential care facilities. The national emphasis program (CPL 03-00-016) became effective on April 3, 2012, and covers establishments in three areas: nursing care facilities, residential mental retardation facilities and continuing care communities. Retirement communities that do not provide medical care are excluded from the emphasis program.

The program directive states that, in addition to addressing ergonomics hazards related to lifting patients, OSHA will focus its attention on compliance with blood-borne pathogens standards and look for strategies to prevent workplace violence, tuberculosis and falls. An interesting point about this enforcement initiative is that it focuses on two areas – workplace violence and ergonomics – where OSHA has yet to promulgate specific standards. As such, it is expected that OSHA's use of the general duty clause when issuing citations is sure to increase.

Employers may be identified for inspection if they have experienced an above-average DART rate during 2010. The average DART rate in 2010 for the three identified businesses in this emphasis program was 4.7. OSHA's national office has been tasked with preparing a list of at least 700 establishments where the DART rates warrant inspection. It is expected that each OSHA area office will conduct at least three inspections each year, through 2015.

Employers in the identified businesses should expect OSHA inspectors to destermine whether the facility has adequate devices to assist with lifting and moving patients and to determine whether procedures and policies are appropriate to reduce worker exposure to ergonomics hazards. One of the tactics which OSHA may use to make such determination is to videotape patients being moved by workers in the facility (as long as the inspector has written consent from the patient). Inspectors are also likely to evaluate the employer's written exposure control plan, determine whether the establishment asked for employee suggestions while drafting the plan, assess the use of protective equipment, check the sharps injury logs and investigate procedures for action when an employee comes in contact with blood or other potentially infectious material.