OSHA Enforcement

This section directs employers and employees to OSHA enforcement policy and guidance documents that pertain to nursing and residential care facilities.

Directives and Enforcement Policies

The following are selected OSHA Directives and Instructions which provide guidance on the agency's enforcement procedures, explain OSHA's requirements, and describe how they apply in a particular situation.

• Enforcement Procedures and Scheduling for Occupational Exposure to Workplace Violence. CPL 02-01-058, (January 10, 2017).
• Inspection Guidance for Inpatient Healthcare Settings. OSHA Memorandum, (June 25, 2015).
• Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens. CPL 02-02-069 [CPL 2-2.69], (November 27, 2001). Includes revisions mandated by the Needlestick Safety and Prevention Act.
  • Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 50(RR11), (June 29, 2001). Updates and consolidates recommendations for the management of health-care personnel (HCP). Serves as Appendix E for CPL 02-02-069.
  • Updated U.S. Public Health Service for the Management of Occupational Exposure to HIV and Recommendations for Postexposure Prophylaxis. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 54(RR09); 1-17, (Sept. 30, 2005). Updates previous recommendations for the management of health-care personnel (HCP) who may have been occupationally exposed to HIV.
• Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis. CPL 02-02-078, (June 30, 2015). Provides general enforcement policies and procedures to be followed when conducting inspections and issuing citations related to occupational exposure to tuberculosis (TB).

Letters of Interpretation

The following are selected letters of interpretation which explain OSHA's requirements and how they apply in a particular situation. Note that enforcement guidance may be updated in response to new information and affected by changes to OSHA rules. To keep informed about such developments, you can visit OSHA's website. Example letters are listed below.

• Applicability of OSHA's bloodborne pathogens standard to the containment and disposal of electric razors in correctional facilities and health care settings. (January 2, 2008).
• Containment and disposal requirements for disposable razors used in long-term health care facilities for personal grooming. (March 28, 2005).
• Tuberculosis and Respiratory Protection. (July 30, 2004). Defines the updated enforcement policy for tuberculosis under 29 CFR 1910.134. Effective July 2, 2004, covered establishments must comply with 29 CFR 1910.134 when using respirators for protection from tuberculosis (TB).
• Safer medical devices must be selected based on employee feedback and device effectiveness, not Group Purchasing Organizations. (November 21, 2002).
• Use of height adjustable beds help reduce back injuries during patient care. (June 15, 2000).
• Bloodborne pathogens standard requirements regarding employees performing residential services. (September 4, 1992).
• Application of provisions of the Bloodborne Pathogens standard to Funeral and Nursing Homes. (June 1, 1992).

Ergonomics Enforcement

• Ergonomics Enforcement. OSHA Safety and Health Topics Page. Serious ergonomics hazards in nursing and residential care facilities will be addressed using Section 5(a)(1) of the OSH Act, often referred to as the General Duty Clause.