New York-based Montefiore Medical Center fined for workplace violence violations

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Montefiore Medical Center, an academic medical center in New York City that’s part of the Montefiore Health System, has been hit with a fine from the U.S. Labor Department’s Occupational Health and Safety Administration after it found that many employees, including nurses and technicians, were exposed to workplace violence.

The hospital was fined more than $17,000 – about $13,600 for failing to protect employees and another $4,000 for incomplete and inaccurate illness incident reports.

The lack of adequate safeguards, highlighted by employee complaints, were found primarily in the Children’s Hospital at Montefiore, where OSHA found evidence of exposure to workplace violence.

In some cases, physical assaults from violent patients occurred during one-on-one patient observations, while restraining patients during assaults and attempted escapes, and while performing holds on or restraining patients. The alleged incidents resulted in worker injuries, including broken bones, bites, and neck, back and shoulder injuries. The injuries caused some employees to miss work.

OSHA determined that Montefiore’s workplace violence prevention program was inadequate and lacked effective engineering and administrative controls and employee training to protect workers against the recurring hazard of workplace violence.

The agency cited Montefiore for one serious violation under the general duty clause – for not providing a workplace free from recognized hazards likely to cause death or serious physical harm to employees. OSHA also cited the facility for less serious violations, such as for incomplete, inaccurate and untimely injury and illness incident reports.

“This employer ignored repeated episodes of physical assault that put their employees at risk,” OSHA Area Director Robert T. Garvey in Tarrytown, New York, said in a statement. “Employers can and must reduce workplace violence hazards by implementing and maintaining an effective workplace violence prevention program, which is an essential safeguard for these essential workers.”

WHAT’S THE IMPACT?

Montefiore Medical Center is an academic medical center and the primary teaching hospital of the Albert Einstein College of Medicine in the Bronx. The Montefiore Health System consists of 15 hospitals and a primary and specialty care network of more than 180 locations across Westchester County, the lower Hudson Valley and the Bronx.

The employer has 15 business days from receipt of its citations and penalties to comply, request an informal conference with OSHA’s area director, or contest the findings before the independent Occupational Safety and Health Review Commission.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to ensure these conditions for America’s workers by setting and enforcing standards, and providing training, education and assistance.

THE LARGER TREND

Workplace violence in healthcare is an issue exacerbated by the challenges of COVID-19, according to National Nurses United.

A union survey done in November 2020 shows that, of the 15,000 registered nurses nationwide who responded, 20% reported they were facing increased workplace violence. That’s according to Michelle Mahon, assistant director of nursing practice for the professional association of registered nurses, which has more than 170,000 members nationwide. Most of the violence, both physical and verbal, is from patients to staff.

The cost of covering violence-preventing security measures, whether in the form of hiring security staff, installing security infrastructure and providing training for staff, is a big expense, according to an American Hospital Association 2017 Cost of Community Violence to Hospitals and Health Systems report by Milliman.

Milliman analyzed the financial statements of 178 California hospitals and found that about 0.5% of total expenses were dedicated to security costs. This suggests that hospitals spent $4.7 billion on security in 2016 and that $847 million of this cost addresses violence.

The number of hospitals with workplace-violence-prevention programs increased between 2016 and 2018 – from 47.1% in 2016 to 53% in 2017 and 55.5% in 2018, according to another AHA report, the 2020 Environmental Scan.

In a 2015 report, OSHA said, “Healthcare and social assistance workers experienced 7.8 cases of serious workplace violence injuries per 10,000 full-time equivalents in 2013. Other large sectors, such as construction, manufacturing and retail all had fewer than two cases per 10,000 FTEs.”
 

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