Safety and Ergonomics for Extended Care Facilities

Course Development Team

• Mike Rienerth, Ergonomics Consultant, BWC• Mike Donohue, Safety Consultant, BWC• Greg Nartker, Ergonomics Consultant, BWC• George Kunz, Safety Consultant, BWC• Rick Hughes, Manager of Occupational Safety &

Health, Ohio Masonic Homes• Mel Tobias, Safety Compliance Manager,

Sprenger Retirement Centers• Marty Grant, Curriculum Designer, BWC

BWC - Safety & Hygiene Services

• Consultative services to assist with safety, ergonomics, and occupational health issues

• Already paid for through WC premiums

• Non–regulatory; no enforcement power

• No reporting to enforcement agencies

“Extended-care facilities” include:• Nursing homes

• Mental health facilities

• Full-time care facilities

• Long-term care facilities

• Other?

Definition

COURSE OBJECTIVES

• Gain a better appreciation for the benefits of an effective safety & health process

• Learn about tools and resources that can be used to enhance safety management systems

• Review common OSHA compliance requirements for extended care facilities

COURSE OBJECTIVES

• Learn about tools and resources that can be used to assist with OSHA compliance

• Review common ergonomic issues and control measures for extended care facilities

• Discuss management strategies that can assist in the implementation of safety and ergonomics improvements

What are your objectives?

• Introduce yourself– Name– Occupation– Facility

• Mention one of your objectives for attending this course

Key Questions

• Who is responsible for safety at your facility?

• Who is accountable for safety performance at your facility?

Regulatory Compliance

• Ohio Department of Health (ODH)– Resident safety

• Joint Commission for Accreditation of Health Organizations (JCAHO)– Resident safety

• Occupational Safety & Health Administration (OSHA)– Staff safety

OSHA 5(a)(1) – General Duty Clause

• 1970 OSH Act

• Each employer shall furnish… a workplace free of recognized hazards…

OSHA Recordable Injury/Illness Incidence Rates

0

2

4

6

8

10

12

14

1999 2000 2001 2002

Private Industry

Hospitals (SIC 806)

EC Facilities (SIC 805)

What is Your Facility’s OSHA Recordable Incidence Rate?

IR = # of OSHA Recordables x 200,000# of exposure hours (hrs. worked)

The IR represents the number of OSHA recordable injuries/illnesses per 100 full time workers over a given period of time

Days Away, Restricted and/or Transferred (DART Rate) (BLS)

0

1

2

3

4

5

6

7

8

1999 2000 2001 2002

Private IndustryHospitals (SIC 806)EC Facilities (SIC 805)

Estimate your Experience

Type of injury Your percentage Possible Causes

Overexertion

Slips/Falls

Contact with

Struck by

Caught in/on or between

Types of Injuries in EC Facilities

51%

17%11%

7%

14%

OverexertionSlip/Trip/FallContact w/objectsAssaults/ViolenceOther

Money Matters

What does your facility currently pay?• Workers’ compensation coverage

• Healthcare insurance

• Liability insurance

• Property insurance

• Other

What are the Costs of an Ineffective Safety Process?

• The average cost for a medical only injury in Ohio is $800

• The average cost for a lost-time injury in Ohio is $44,000 (medical + indemnity + reserves)

• Average workers’ comp premiums for a base rated 100-bed facility are about $160,000/year

• Average workers’ comp premiums for a group rated 100-bed facility are about $80,000/year

Average Annual Workers’ Comp Premiums for EC Facilities

$0

$50,000

$100,000

$150,000

$200,000

$250,000

$300,000

$350,000

$400,000

0.5 1 1.5

50 Bed

100 Bed

200 Bed

Experience Modifier (EM)

Employer Rating Plan History

Payroll period beginning date

Payroll period ending date

Experience rate Employer rating plan

7/1/2004 12/31/2004 44% GROUP

7/1/2003 12/31/2003 57% GROUP

7/1/2002 12/31/2002 82% EXP

7/1/2001 12/31/2001 110% EXP

7/1/2000 12/31/2000 127% EXP

7/1/1999 12/31/1999 143% EXP

7/1/1998 12/31/1998 172% EXP

7/1/1997 12/31/1997 220% EXP

What are Some Other Costs of an Ineffective Safety Process?

• 10 to 20% of people leave the nursing profession due to injury

• Average turnover rate of STNAs in nursing homes is 50-60%

• Average cost to recruit, hire, and train a STNA = $2,000 - $ 3,000

• The average cost of OSHA citations for HC facilities is approximately $10,000 to $15,000 per inspection

Iceberg AnalogyAccident Cost

•Medical Payments•Compensation

Supervisor time to investigate

Breaking in substitute

Poor efficiency due tobreak-up of crew

Damaged equipment

Administrative costs

Temporary workers

Loss of good will

Overtime by employees

Change in WC rating

Lost time by fellow workers

Direct Costs

Indirect or HiddenCosts

What motivates safety activities in your facility?

Safety & Ergonomics ProcessThe BenefitsThe Benefits

• Compliance and hazard prevention

• Reduced injuries and lost time

• Lower worker compensation costs

• Lower absenteeism and turnover

• Better employee relations and morale

• Better Quality Care!

Strengths and Weaknesses

• What is one thing that your facility does well to ensure staff safety?

• What is one thing that you feel your facility needs to address to improve staff safety?

Elements of an Effective Safety & Ergonomics Process

Management Commitment Employee Involvement Accountability Documentation Integration Communication Monitoring/Evaluation Flexibility Continuous Improvement