Did OSHA just tell nursing homes to cut back on care?

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John O'Connor
John O'Connor

The Occupational Safety and Health Administration dropped the hammer on a Colorado facility last week.

Regulators hit the Pioneer Health Care Center in Rocky Ford with a $9,000-plus fine. The reason: The facility failed to protect staff from physically violent residents.

Should Pioneer accept OSHA's findings, it will be required to install more security cameras and security alarms, remove dangerous items from the rooms of patients identified as violent and improve training and staffing levels.

Given what's happened, OSHA's response might seem reasonable. At least on paper.

After all, no person this side of the MMA should face the risk of routinely being grabbed, kicked, punched, gouged or bitten on the job. Moreover, employers should take every reasonable step to ensure a safe working environment. Who could argue otherwise?

But I do have a question for the person or people who wrote up the OSHA violations: Was this the first time you actually stepped foot in a skilled care facility?

For if you had spent a fair amount of time in nursing homes, you would eventually discover something all caregivers must learn. And that something is this: Old people don't always play nice.

Some are confused. Some are frightened. Some don't like people with dark skin or unfamiliar accents coming near. Some have no idea where they are. And some are just flat-out mean. I'm not making any accusations here. I'm simply pointing out a reality that hundreds of thousands of frontline caregivers can attest to.

To make matters worse, residents don't typically announce they are about to grab, kick or bite others who might happen to be within striking distance.

So what's a skilled care operator to do?

One option is to deliver every possible amount of care to someone who's not quite right, knowing there's a risk that person may lash out in ways that lead to fines or worse.

A second option is to let that ornery old cuss stew in his or her own juices, fill out the paperwork that makes things look legit, and avoid the wrath of regulators.

Without intending to do so, OSHA has sent a pretty clear message about which option carries less risk.

John O'Connor is McKnight's Editorial Director.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.