The Occupational Safety and Health Administration is cracking down on employers that are not doing enough to protect their employees from workplace violence as a Fairfield nursing home recently learned.
ResCare Inc., which has a residential care facility in Fairfield called Camelot Lake, was fined $8,700 last month by OSHA for exposing its employees to workplace violence. OSHA’s investigative report on the nursing facility found it wasn’t sufficiently protecting employees from potentially violent residents and situations that could lead to serious injury.
ResCare Inc. contested the findings and is looking to resolve the matter with OSHA, said Felicia Hall, the ResCare executive director. The company declined to comment further.
Late last year, OSHA issued a compliance directive on Workplace Violence, ranking among the top four causes of death in workplaces during the past 15 years. According to the Bureau of Labor statistics, more than 3,000 people died from workplace homicide between 2006 and 2010. Numbers also indicate that an average of more than 15,000 nonfatal workplace injury cases were reported annually in the same time frame.
“This is a growing concern for OSHA, about what facilitates workplace violence … there have been a growing number of violations at certain facilities all across the country,” said Scott Allen, a spokesman for the U.S. Department of Labor, which oversees OSHA.
One factor that prompted the concern was the 24-hour retail industry, said Bill Wilkerson, a director at the Cincinnati OSHA office, including but not limited to late-night store clerks.
“It has kind of gone from there to look at the big picture in all the different industries, where it’s been typically experienced … the agency has either directly or indirectly, through its sister agency, published some guidance for late-night retail and other particular types of industries,” he said. The sister agency is NIOSH, the National Institute for Occupational Safety and Health.
OSHA has issued a fact sheet on workplace violence stating that some two million workers are victims each year. Recently in Fresno, Calif., a gunman at a packaging plant shot four people, two of them fatally, before turning the gun on himself.
OSHA recommends that employers establish a zero-tolerance policy against violence by or for their employees. It also suggests that employees learn how to recognize and diffuse violent situations by attending safety training programs, reporting incidents to supervisors, avoiding traveling alone and carrying minimal amounts of money.
“When it comes to dealing with those kinds of industries where the the threat of workplace violence has been based on experience, we’re looking for those employers to take some steps to try to address it.” Wilkerson said.
Typically, what businesses are lacking are procedures to protect workers, or even recognizing certain violent situations.
“A lot of times it depends on what exactly the industry is and what you can do. In late night retail, you don’t want to have as much cash on hand accessible by employers. Less cash on hand would not present as tempting of a target,” Wilkerson said.
One might not expect violence to occur in nursing homes, but OSHA put its attention on them earlier this year, focusing on nursing homes with a days away, restricted transfer, or “DART,” rate of 10 or higher per 100 full-time workers. The investigation found that Camelot Lake accumulated 20 workplace violence cases from 2009-2012, resulting in 53 days away from work and 37 days of restricted duty. The nursing homes must report such incidents in logs reviewed by OSHA, Allen said.
“Employees have been exposed to physical assaults during routine interaction with residents who have a history of violent behavior,” an investigation report said.
Wilkerson said the facility’s emphasis is on caring for people with developmental disabilities who may not necessarily be elderly. ResCare Ohio employs more than 270 workers, including 50 at the Camelot Lake facility who care for up to 36 clients. Wilkerson is also negotiating the settlement with ResCare Inc.
This case was discovered in the midst of OSHA investigating ergonomic injures from repeated motion and/or lifting, he said. This inspection was OSHA’s fourth of the facility. None of the previous inspections resulted in citations for workplace violence.
The employees at Camelot Lake are “nice people, but they do have a special challenge, so we want to work with them to develop a program” to address their issues, Wilkerson said.
According to OSHA, nursing homes and personal care facilities had one of the highest rates of injury and illness in 2011 among industries for which lost workday injury and illness rates are calculated The Bureau of Labor Statistics states these facilities experienced an average injury rate of 4.9 per year compared with 1.8 for private industry as a whole.
Among elderly residents, Most of the incidents of violence tend to occur with patients suffering from Alzheimer’s, dementia, or another condition that affects cognitive function, said Danielle Webb, the spokeswoman for Colonial, a Hamilton-based company that operates assisted living facilities in the Hamilton area, including Berkeley Square and Westover. Those facilities house about 400 residents.
“A lot of times when people have Alzheimers and dementia, they have a hard time communicating, and they also don’t understand things, necessarily,” Webb said. And that can lead to confrontations, particularly when those patients are being given baths, she said.
“There tends to be resistance to water, but it’s also something that’s very private and very personal that you’ve done yourself your whole life, and you don’t know who this person is and what they’re doing to you” she said. “That’s when people tend to act out.”
Such incidents happen very rarely at Colonial. Webb said she could not recall any in the past four years. The company takes a number of measures to prevent such incidents, Webb said.
“We do specific Alzheimer’s-related training for all staff, not just nurses and nurses’ aides. We have an interdisciplinary approach to care, so every week they have a meeting with a pharmacist, a physician, a therapist if they’re in therapy, the director of nursing, and we also do a lot of family outreach,” Webb said.
Training can include making the staff more empathetic with the patients to understand what their situations are like, Webb said.
“You take it for granted that you can wake up in the morning and get out of bed. Some people are totally dependent on whenever you get around to getting in the room and getting them out of bed,” Webb said.
In addition to keeping the staff well trained, it’s also important to keep the staff consistent, maintaining the same staff in certain areas at certain times, she said.
“If you see Dinah every night, then we only keep Dinah in that area. In some nursing homes, it’s just whoever shows up and is on the floor and they go wherever they’re needed. We stay really consistent with who we put in specific areas so that they can become more comfortable and develop more of a relationship with that person,” Webb said.
Understaffing can also be a concern, meaning that employees can be reactive and try to hurry things. One of the things that we do is make sure we have more than enough staff all the time so that we do have time to sit down and communicate and help people understand,” she said.