OSHA Enforcement Effort with Focused Inspections in Hospitals and Nursing Care Facilities Treating COVID-19 Patients

Special Bulletin
March 8, 2022


The Department of Labor’s Occupational Safety and Health Administration (OSHA) today announced the start of a short-term increase in focused inspections directed at hospitals and skilled nursing care facilities that treat or handle COVID-19 patients.

This focused inspection initiative supplements OSHA’s ongoing targeted enforcement efforts under the COVID-19 National Emphasis Program (NEP). Together, these initiatives are expected to comprise 15% of OSHA’s enforcement activity per region.

Under the new initiative, OSHA will expand its presence in targeted “high-hazard” health care facilities during a three-month period from March 9 to June 9. Targeted health care facilities include general medical and surgical hospitals, psychiatric and substance abuse hospitals, skilled nursing facilities and assisted living facilities for the elderly.

OSHA’s stated goal is to ensure continued efforts to control the spread of COVID-19 and any future variants. In doing so, the agency will conduct focused follow-up and monitoring inspections of previously inspected or investigated health care facilities and assess employers’ compliance actions, including employers’ readiness to address any ongoing or future COVID-19 surges. Health care facilities may be selected for inspection if they meet one of the following criteria:

  1. Facility received a COVID-19-related citation or hazard alert letter as a result of a prior inspection;
  2. Facility was subject of a now-closed COVID-19 case involving unannounced surveys or investigations, such as complaint surveys or rapid response investigations conducted in response to an employer’s report of a severe injury; or
  3. Facility previously received a COVID-19-related citation as a result of a remote-only COVID-19 inspection.

These assessments will be limited to:

  • Determining whether previously cited COVID-19-related violations have been corrected or are still in the process of being corrected.
  • Determining whether the employer has implemented a COVID-19 plan that includes measures for the SARS-CoV-2 virus.
  • Verifying the existence and effectiveness of all control measures, including procedures for determining vaccination status by reviewing relevant records. OSHA will refer any vaccination-related deficiencies to the Centers for Medicare & Medicaid Services.
  • Requesting and evaluating the organization’s COVID-19 log and the injury and illness logs for 2020-2022, if available, to identify work-related cases of COVID-19.
  • Reviewing the facility’s procedures for conducting hazard assessments and protocols for personal protective equipment use.
  • Conducting limited records review of the employer’s respiratory protection program.
  • Performing a limited, focused walk-around of areas designated for COVID-19 patient treatment or handling (e.g. common areas, walkways, and vacant treatment areas where patients have been or will be treated), including performing employee interviews to determine compliance.


OSHA on Dec. 27 announced its decision to withdraw its health care COVID-19 emergency temporary standard (ETS), originally issued June 21. AHA urged such action to the agency in its Aug. 20 comment letter. The Occupational Safety and Health Act requires the agency to finalize an ETS within six months of promulgation; a final standard was not released by Dec. 21, resulting in the withdrawal.

In withdrawing the ETS, OSHA indicated that it would continue to work toward a permanent COVID-19 health care standard. The agency also stated that it would accept compliance with the health care ETS as satisfying employers’ obligations under its existing standards, including the OSHA General Duty Clause and the Personal Protective Equipment and Respiratory Protection standards. In addition, other standards that remain in place and enforceable include recording and reporting of occupational injuries and illness, access to employee exposure and medical records, the health care ETS COVID-19 log, and availability of records and reporting of COVID-19 fatalities and hospitalizations.


If you have questions, please contact AHA at 800-424-4301.

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