Breaking down the term “in-patient hospitalization”
In a January 1, 2015, revision to the recordkeeping rule, a significant change was made that requires employers to report to OSHA all work-related in-patient hospitalizations of one or more employees within 24 hours of learning about it. While the concept of in-patient hospitalization may seem intuitive, it has been a cause of confusion among safety professionals.
According to 1904.39(b)(9), in-patient hospitalization means a formal admission to the in-patient service of a hospital or clinic for care or treatment. For a better understanding of the requirements, one must break down the definition even further.
Formal admission
Formal admission involves a combination of various factors, including whether the patient will receive additional care such a surgical procedures, is too sick to stay at home, or will be staying more than 24 hours. Ultimately, the hospital or clinic makes the determination to whether an employee was formally admitted to the in-patient service of a hospital or clinic.
Keep in mind, where the employee is admitted matters as well. If an employee was formally admitted to the Emergency Room this would not be considered reportable. Being admitted to the Emergency Room for outpatient care, such as getting sutures, is different than being formally admitted for in-patient care or treatment. Of course, the Emergency Room admittance could turn into formal admission to in-patient service, so it’s important to stay in contact with the appropriate individuals during this time.
It is also important to keep a close eye on the time duration between onset of injury and when the employee does receive formal admission for in-patience services. An employee may be admitted to the hospital for knee surgery, but if this scheduled surgery occurred more than 24 hours after the workplace incident, a call to OSHA is not required.
Care or treatment
Two key words are “care” and “treatment.” The employer does not have to report an in-patient hospitalization if it was for diagnostic testing or observation only.
The conduct of diagnostic procedures includes things such as X-rays, MRIs, Cat Scans, EMGs, and blood tests, including the administering of prescription medications used solely for diagnostic purposes. If a pregnant employee suffers a fall while at work and is taken to the hospital to undergo an MRI to rule out any potential issues, this would not be considered reportable if the employee was not formally admitted for in-patient services.
While OSHA provides ample resources regarding injury and illness recordkeeping and when to report an injury or fatality, there is still a great deal of information to unpack. Knowing how to read into and interpret the regulations will allow for greater focus on preventing fatalities and serious work-related injuries and illnesses.