OSHA fines Saint Alphonsus for COVID-19 worker safety violations

The Occupational Safety and Health Administration has fined Saint Alphonsus Regional Medical Center for two violations of worker health and safety rules related to COVID-19.

The violations stem from a complaint made on Sept. 16. That was the day Idaho first entered into crisis standards of care, as hospitals statewide struggled under a crush of COVID-19 patients.

Public records show that OSHA opened an investigation Sept. 22 into the complaint against the Boise hospital — part of the Saint Alphonsus Health System that belongs to Michigan-based Trinity Health.

The OSHA inspectors found two serious violations and issued a $14,630 penalty. However, in the settlement process, OSHA changed the violation category from “serious” to “other” and reduced the penalty to $11,704.

The inspection found that Saint Alphonsus violated federal standards that require employers to:

• conduct an assessment to identify potential workplace hazards related to COVID-19. The violation exposed 40 employees to a COVID-19 hazard, according to the OSHA record.
• give employees additional training whenever the employee’s job duties change in a way that puts them at risk of contracting COVID-19 at work. That violation exposed 40 employees to a COVID-19 hazard, according to its OSHA record.

Saint Alphonsus Health System said in an emailed statement Wednesday that OSHA conducted an on-site inspection after the complaint.

“Saint Alphonsus takes colleague safety and its OSHA obligations very seriously, and its commitment to ensuring a safe work environment has been a continued focus of the organization prior to and throughout the pandemic,” the statement said. “This commitment is evidenced by Saint Alphonsus’ implementation of various infection prevention strategies and ongoing COVID-19 training for colleagues, including training on the use of appropriate personal protective equipment in the workplace.”

The health system said that the delta-fueled surge of COVID-19 patients last fall forced Saint Alphonsus to implement parts of its surge plans “that had not previously been needed, which included creating a COVID-19 unit within its inpatient Behavioral Health Unit (BHU) for COVID+ psychiatric patients who did not require medical intervention.”

According to the complaint that prompted the inspection:

• Saint Alphonsus converted the children’s section of its behavioral health facility into an overflow COVID-19 unit. But the hospital “did not train or communicate” with workers about the changes.
• Employees had no “appropriate area” to put on and remove their PPE. Federal health officials have provided detailed and specific guidance for this process, to prevent contaminating areas beyond a COVID-19 patient’s isolation area.
• Staff with PPE on — including gowns, N95 respirators and goggles — would travel between the COVID-19 overflow unit to areas for people without COVID-19.
• There was no negative-pressure ventilation system in the facility to keep aerosolized COVID-19 particles within the COVID-19 isolation area. (Those negative-pressure systems, that continuously pull air out of a room, are standard in hospital COVID-19 units.)
• In addition, cleaning and sanitation procedures “were not put into place” for the adjacent areas.
• Workers had N95 respirators, but they “were required to work” in the COVID-19 overflow unit without “the opportunity” to shave. At least one employee had a full beard. (Facial hair breaks the seal on a properly fit respirator, allowing particles to leave and enter the mask.)
• “Temporary hospital staff were required to wear N95 respirators without fit testing.” Fit testing is a process that identifies which size and style of N95 respirator achieves the proper fit on an individual’s face.

Saint Alphonsus told the Sun in its emailed statement Wednesday that, while the complaint cited six issues, OSHA only required the hospital to fix two of them.

“While Saint Alphonsus denied the allegations in the complaint, it worked cooperatively with OSHA to resolve and close the matter through the provision of additional colleague training and enhancement of its existing hazard assessment program,” the statement said.

— Audrey Dutton is a senior investigative reporter for the Idaho Capital Sun. This article was originally published on idahocapitalsun.com.