OSHA Regulation of Infectious Disease in Long Term Care | https://publish.ahcancal.org/News-and-Communications/Blog/Pages/OSHA-Regulation-of-Infectious-Disease-in-Long-Term-Care.aspx | OSHA Regulation of Infectious Disease in Long Term Care | | | | | 3/26/2024 4:00:00 AM | | <p></p><div>While the Occupational Safety and Health Administration (OSHA) does not currently have a specific infection prevention standard tailored for long term care facilities, it regulates employee exposure to infectious disease through the <a href="https://www.osha.gov/laws-regs/oshact/section5-duties" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">OSHA General Duty Clause</a> and existing standards, like the <a href="https://www.osha.gov/bloodborne-pathogens/standards" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Bloodborne Pathogen Standard</a>. OSHA is also drafting and expected to issue a more comprehensive infectious disease standard. </div><div> <br></div><div><strong>Current Regulation Status</strong> <br></div><div> </div><div>Traditionally, OSHA has focused on disease transfer through blood or other potentially infectious fluids because the Bloodborne Pathogen Standard narrowly addressed those modes of transmission. Years before the emergence of COVID-19, however, OSHA began to look at the spread of infectious disease more broadly, and it continued those efforts throughout the pandemic. </div><div> </div><div>Currently, OSHA requires health care providers to continue following the Bloodborne Pathogen Standard and also implement known and feasible methods of preventing the spread of infection through contact, droplet, and airborne transmission. OSHA has published <a href="https://www.osha.gov/healthcare/infectious-diseases" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">guidelines on infection control</a>, many of which may already be used by health care providers to address patient or resident safety. OSHA enforces compliance with those guidelines through the General Duty Clause as discussed previously in <a href="/News-and-Communications/Blog/Pages/Ergonomics-201-Controls-State-Regulations-and-Resources.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Ergonomics 201: Controls, State Regulations, and Resources</a> and <a href="/News-and-Communications/Blog/Pages/Addressing-the-Challenge-Workplace-Violence-in-LTC-Setting.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Workplace Violence in LTC</a>. Within those standards and guidelines, providers should also be mindful of related OSHA standards, like the <a href="https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Respiratory Protection Standard 1910.134</a> which is triggered when addressing airborne hazards, or the <a href="https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.132" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">1910.132 - PPE General Requirements</a> which includes other precautions, like gloves, gowns, and eye protection. </div><div><br></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;text-decoration:underline;"><div dir="ltr" style="text-align:left;"><span style="font-size:11pt;"><strong>State OSHA Standards</strong></span></div></blockquote><div><br></div><div><span style="font-size:11pt;">Some states have their own Occupational Safety and Health (OSH) programs as identified in the <a href="/Survey-Regulatory-Legal/Documents/A%20Roadmap%20to%20OSHA%20Requirements.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Roadmap to OSHA Requirements</a>, which may introduce additional regulations or standards surpassing federal OSHA requirements. For example, California's Cal/OSHA program has implemented specific regulations under the Aerosol Transmissible Diseases (ATD) standard, mandating stringent measures to prevent the transmission of infectious diseases in health care settings, including long term care facilities. </span></div><div><br></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;text-decoration:underline;"><div><span style="font-size:11pt;"><strong>Temporary Standards</strong></span></div></blockquote><div><br></div><div>During public health crises, like the COVID-19 pandemic, OSHA may also issue temporary standards and specific guidance to address the evolving safety concerns in workplaces, including long term care centers. </div><div> </div><div>These guidelines offer tailored recommendations to protect workers from exposure to infectious diseases and ensure their safety amidst challenging circumstances. These precautions are enforced either through an Emergency Temporary Standard, as was used with COVID-19, or through the General Duty Clause. </div><div><br></div><div><span style="font-size:11pt;"><strong>Proposed Infectious Disease Standard </strong></span></div><div> <br></div><div>While there is no broad infectious disease standard for long term care centers currently, OSHA is developing more comprehensive regulations. The new standard is likely to address critical aspects, such as airborne and droplet precautions, engineering control measures, personal protective equipment (PPE), respiratory protection, hazard assessment and control, training and education, recordkeeping, and reporting. As with other OSHA standards, many of the requirements for the new infectious disease standard may already be addressed in providers’ resident or patient care policies, but there will almost certainly be new documentation and similar requirements. </div><div> </div><div>Resources, such as regulatory agenda items, Requests for Information (RFI), stakeholder summary reports, and Small Business Advocacy Review Panel (SBAR Panel) Final Reports, serve as valuable references in understanding OSHA's initiatives on infectious diseases in the workplace: </div><div><span style="font-size:11pt;"><br></span></div><div><ul><li><span style="font-size:11pt;">Regulatory agenda item (Spring, 2017) which explains more about OSHA's Infectious Diseases efforts: <a href="https://resources.regulations.gov/public/custom/jsp/navigation/main.jsp" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">https://resources.regulations.gov/public/custom/jsp/navigation/main.jsp </a><br><br></span></li><li><span style="font-size:11pt;"><a href="https://www.regulations.gov/document?D=OSHA-2010-0003-0001" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Infectious Diseases RFI</a> and comments to the RFI (<a href="https://www.regulations.gov/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">www.regulations.gov</a> - Docket #OSHA-2010-0003). <br><br></span></li><li><span style="font-size:11pt;"><a href="https://www.regulations.gov/document?D=OSHA-2010-0003-0236" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Infectious Diseases Stakeholder Summary Report </a><br><br></span></li><li><span style="font-size:11pt;"><a href="https://www.regulations.gov/document?D=OSHA-2010-0003-0239" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Small Entity Representative Background Document </a></span></li></ul></div><div><br></div><div><span style="font-size:11pt;">With infectious disease, regardless of the method of transmission, employee safety is tied closely with the safety of residents and patients. OSHA’s current standards and guidelines certainly place an additional regulatory burden on health care providers, but the basic principles of infection control remain the same. </span></div><div> </div><div>In an upcoming blog, AHCA/NCAL will provide additional insight and best practices to help long term care providers comply with OSHA’s employee-centric infection control regulation. </div><div><br><br></div><p></p> | While OSHA does not currently have a specific infection prevention standard tailored for long term care facilities, it regulates employee exposure to infectious disease.
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Addressing the Challenge: Workplace Violence in LTC Setting | https://publish.ahcancal.org/News-and-Communications/Blog/Pages/Addressing-the-Challenge-Workplace-Violence-in-LTC-Setting.aspx | Addressing the Challenge: Workplace Violence in LTC Setting | | | | | 3/20/2024 4:00:00 AM | | <p></p><div>Long term care (LTC) centers have always served as a place of comfort and safety for the elderly and individuals with disabilities, providing essential support and care in their daily lives. Unfortunately, in recent years, the issue of workplace violence in health care has gained increased national attention, and LTC centers are not immune. This article will cover some of the practical and regulatory issues with workplace violence in LTC settings, exploring its history, expectations, and anticipated action for prevention and intervention. It is essential that we understand this challenge and implement proactive measures. </div><div><br></div><div style="text-decoration:underline;"><span style="font-size:11pt;"><strong>History:</strong></span></div><div><br></div><div><span style="font-size:11pt;">The Occupational Safety and Health Administration (OSHA) does not have, and has never issued, a formal workplace violence standard. Instead, since the late 1980s and early 1990s, OSHA has used the General Duty Clause to cite employers that do not follow basic workplace violence precautions. The clause states that “all employers have a duty to provide a place of employment “free from recognized hazards that are causing or are likely to cause death or serious injury.” </span></div><div><br></div><div><span style="font-size:11pt;">Traditionally, even in LTC settings, workplace violence has always been thought of in terms of active-shooter scenarios or domestic violence extending into work, but increasingly, OSHA is focusing on a much more common occurrence: resident-on-employee violence. OSHA is currently in the process of creating a formal regulation to address resident behaviors in health care (the RFI is available <a href="https://www.federalregister.gov/documents/2016/12/07/2016-29197/prevention-of-workplace-violence-in-healthcare-and-social-assistance" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">here</a>). However, because the timing of this new standard is not yet known, OSHA is trying to reduce instances of resident-on-employee violence by applying its General Duty Clause, which was previously covered in a <a href="/News-and-Communications/Blog/Pages/Safe-Resident-Handling-and-Prevention-of-Musculoskeletal-Injuries-Ergonomics-in-Long-Term-Care-Communities.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">previous article</a>. Like in ergonomics, OSHA’s enforcement of the General Duty Clause for workplace violence is based on OSHA’s guidelines and expectations. As such, it is important to understand OSHA’s current expectations for prevention of workplace violence and anticipated action going forward. </span></div><div><br></div><div style="text-decoration:underline;"><span style="font-size:11pt;"><strong>C</strong></span><span style="font-size:11pt;"><strong>urrent expectations: </strong></span></div><div><br></div><div><span style="font-size:11pt;">OSHA defines workplace violence broadly to include “any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site. It can affect and involve workers, clients, customers, and visitors. [workplace violence] ranges from threats and verbal abuse to physical assaults and even homicide.” To reduce incidence of workplace violence, OSHA’s first recommendation is to develop a “zero-tolerance policy” covering staff, patients, visitors, and others, but that recommendation is difficult, if not impossible, to implement in most LTC settings. A more achievable expectation is to create a “Workplace Violence Prevention Program” to include a hazard analysis, control measures, training, and continued program re-evaluation. </span></div><div><br></div><div><span style="font-size:11pt;">Hazard analysis can be completed on multiple levels, including as an entire facility, by unit, or by individual resident or patient. Facility-wide hazards might be, for instance, low lighting in certain areas or limitations for communication between staff. Resident-specific factors might include a history of violence, behaviors, or volatility. Fortunately, many LTC centers already complete resident-specific care plans that often identify a history of behaviors and implement interventions to address those behaviors. For all hazard assessments, OSHA recommends involving both facility management and staff. </span></div><div><br></div><div><span style="font-size:11pt;">Controls will be highly dependent on the facility and resident population and, therefore, cannot be identified by a comprehensive list. </span></div><div><br></div><div><span style="font-size:11pt;">Some examples from the hierarchy of controls might include: </span></div><div><br></div><div><ul><li><span style="font-size:11pt;"><span style="text-decoration:underline;">Substitution</span>: While it may not always be possible, OSHA suggests that a facility’s best control might be “transferring a client or patient to a more appropriate facility” that is better suited to care for the resident and protection of others. <br><br></span></li><li><span style="font-size:11pt;"><span style="text-decoration:underline;">Engineering</span>: One control often mentioned in OSHA enforcement documentation is improving communication with other employees to call for help. In many instances, this might be a phone system, while in other high-risk settings, a panic button might be recommended. Additionally, OSHA often notes that improved monitoring and visibility can help reduce injuries due to violence, including surveillance cameras and positioning nursing stations in areas with high visibility. Like other controls, these engineering controls are highly facility specific and may not be necessary with certain resident populations. <br><br></span></li><li><span style="font-size:11pt;"><span style="text-decoration:underline;">Work-practice and administrative</span>: The primary work practice controls are resident-specific interventions, likely using care plans or trauma informed care. Additionally, staffing levels and turnover are frequently recognized risk factors. OSHA’s expectation is for a facility/community to have adequate and trained staff, possibly including security guards, to respond to a workplace violence event to minimize the potential for injury. Often, OSHA’s expectations for staffing can simply be having another employee within the area for easy communication to respond to a workplace violence event. <br><br></span></li><li><span style="font-size:11pt;"><span style="text-decoration:underline;">Training</span>: The most significant control for workplace violence is likely employee training. Training might include recognizing patient-specific risk factors, de-escalation techniques, and understanding when to call for help. In LTC centers with a population of mentally declining or incompetent individuals, including those with dementia, training on strategies to understand the patient’s mindset and challenges, like Hand-In-Hand training, might also be included in the Workplace Violence Prevention Program. </span></li></ul></div><div><br></div><div><span style="font-size:11pt;">In addition to hazard analysis and controls, OSHA recommends implementing a system for employees to report incidents and for those incidents to be investigated to determine the root cause. From those reports and investigations, further interventions or controls might be added to your Workplace Violence Prevention Program. </span></div><div><br></div><div><span style="font-size:11pt;">More information on OSHA’s <a href="https://www.osha.gov/workplace-violence" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">current expectations on workplace violence</a> and <a href="https://www.osha.gov/hospitals/workplace-violence" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">worker safety in hospitals</a> can be found on OSHA’s website, and in the following publications: </span></div><div><br></div><div><ul><li><span style="font-size:11pt;"><a href="https://www.osha.gov/sites/default/files/publications/osha3148.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers </a></span><span style="font-size:11pt;"></span></li><li><span style="font-size:11pt;"><a href="https://www.osha.gov/sites/default/files/OSHA3828.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Workplace Violence Prevention and Related Goals: The Big Picture</a> (includes state specific regulation)</span><span style="font-size:11pt;"> </span></li></ul></div><div><br></div><div style="text-decoration:underline;"><span style="font-size:11pt;"><strong>Anticipated Action:</strong></span></div><div><br></div><div><span style="font-size:11pt;">As stated above, OSHA is working through the “notice and comment” process to promulgate a workplace violence regulation specific to health care employers. That said, OSHA has not released an estimated date of issuance. In the meantime,<strong> the best preparation is likely to begin implementing a formal Workplace Violence Prevention Program, using the controls and interventions most appropriate for your facility.</strong> Those should create a solid foundation for any future OSHA regulation. </span></div><div><br></div><div><span style="font-size:11pt;">Workplace violence in long term care settings demands attention and proactive measures. By prioritizing prevention, intervention, and support, facilities/communities can immediately create awareness, which fosters a safer environment for residents and staff. This may include anything from implementing comprehensive violence prevention programs to simply training employees and encouraging a culture of safety. Operators should begin a process where long term care centers minimize the threat of workplace violence, ensuring that residents receive quality care and staff can fulfill their roles with confidence and security. </span></div><div> <br></div><p></p> | Long term care centers have always served as a place of comfort and safety for the elderly and individuals with disabilities, providing essential support and care in their daily lives.
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Navigating OSHA Recordkeeping and the Injury Tracking Application: Complying with the New Requirements | https://publish.ahcancal.org/News-and-Communications/Blog/Pages/Navigating-OSHA-Recordkeeping-and-the-Injury-Tracking-Application-Complying-with-the-New-Requirements.aspx | Navigating OSHA Recordkeeping and the Injury Tracking Application: Complying with the New Requirements | | | | | 3/13/2024 4:00:00 AM | | <p></p><div>The Occupational Health and Safety Administration (OSHA) <a href="https://www.osha.gov/laws-regs/regulations/standardnumber/1904/1904.41" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Standard 1904.41</a> requires certain employers to comply with electronic submission of workplace injuries and illnesses. OSHA's oversight of recordkeeping of workplace incidents has recently become increasingly more focused. </div><div> </div><div>One significant development in OSHA's approach to recordkeeping is the implementation of the Injury Tracking Application (ITA). Launched as part of the <a href="https://www.federalregister.gov/documents/2023/07/21/2023-15091/improve-tracking-of-workplace-injuries-and-illnesses" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Improve Tracking of Workplace Injuries and Illnesses rule</a>, the ITA introduces an electronic platform for certain employers to submit their injury and illness data—i.e., their OSHA 300 logs, form 301, and 300A summary. This post will briefly review OSHA recordkeeping and the ITA, introduce incident rates and DART rates, and discuss implications for employers. </div><div> </div><div style="text-decoration:underline;"><strong>History:</strong><br></div><div><br></div><div>The ITA process for electronic submission of injury and illness data to OSHA was implemented in phases. The <strong>initial</strong> requirement for certain employers to electronically submit their injury and illness summary information became effective on January 1, 2017. The <strong>final</strong> <a href="https://www.federalregister.gov/documents/2023/07/21/2023-15091/improve-tracking-of-workplace-injuries-and-illnesses" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">rule</a> became effective January 1, 2024, and expanded the original rule to include the date, physical location, and severity of the injury or illness; details about the worker who was injured and how the injury or illness occurred. </div><div> </div><div>Under the final rule, OSHA requires certain employers to electronically submit their injury and illness data through the ITA. <strong>Although some employers are exempt, most long term care providers should have submitted the required data by March 2, 2024. </strong></div><div><br></div><div style="text-decoration:underline;"><span style="font-size:11pt;"><strong>Injury/Illness Rates (DART and Incidence):</strong></span></div><div><br></div><div>OSHA recordkeeping, including the OSHA 300 logs, allows OSHA, an employer, or the general public to identify incident rates (Total Recordable Rates) and DART (Days Away, Restricted, or Transferred) rates. The DART rate is a key metric used in occupational safety and health to assess the frequency of workplace injuries and illnesses. It is a commonly used indicator to measure the impact of work-related incidents on a company's workforce. The DART rate is calculated per 100 full-time employees and is often used to compare the safety performance of different companies or industry sectors. </div><div> </div><div>The formula for calculating the <em>Total Recordable Rate</em> and <em>DART</em> Rate is as follows:</div><div style="text-align:center;"><img src="/News-and-Communications/Blog/PublishingImages/Pages/Navigating-OSHA-Recordkeeping-and-the-Injury-Tracking-Application-Complying-with-the-New-Requirements/OSHA20.jpg" alt="OSHA20.jpg" class="ms-rtePosition-4" style="margin:5px;" /> <br></div><div><br><span style="font-size:11pt;">* 200,000 factor is used to standardize the rate per 100 full-time employees working 40 hours per week for 50 weeks. </span><br></div><div><br></div><div style="text-decoration:underline;"><strong>Components of the DART Formula:</strong></div><div><br></div><div><ul><li>Recordable Events: </li><ul><li>The total number of events that resulted in an employee having either Days Away from work or Restricted/Transferred due to a work-related injury or illness. <br></li></ul><li>Total Hours Worked by Employees: <br></li><ul><li>The cumulative number of hours worked by all employees during the reporting period. </li></ul></ul></div><div><span style="font-size:11pt;"><br></span></div><div><span style="font-size:11pt;text-decoration:underline;"><strong>Why DART Rate Matters:</strong></span><br></div><div><br></div><div>DART rates can be used by OSHA and other outside entities to assess your safety and health program, including in the following ways: </div><div><br></div><div style="text-decoration:underline;"><span style="font-size:11pt;"><strong>OSHA:</strong></span></div><div><br></div><div>OSHA uses the DART rate to determine which employers should be inspected under its emphasis programs. For example, OSHA’s <a href="https://www.osha.gov/sites/default/files/enforcement/directives/cpl-02-01-064.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Site Specific Targeting (SST)</a> emphasis program uses lists of eligible companies in the following four categories: </div><div><br></div><div><ul><li>High-Rate Establishments: </li><ul><li>The SST plan selects individual establishments for inspection based on CY 2021 Form 300A data. Because average DART rates vary widely among industries, OSHA will set one DART rate for manufacturing (NAICS 31-33) and a different DART rate for non-manufacturing (all other NAICS, except construction) as objective selection criteria. This method will allow OSHA to equally target manufacturing and non-manufacturing establishments. </li></ul><li><span style="font-size:11pt;">Upward Trending Establishments: </span></li><ul><li>OSHA will identify establishments with rates at or above twice the private sector national average in CY 2019, that have continued to trend upward through CY 2021. <br></li></ul><li>Low-Rate Establishments: </li><ul><li>To verify the reliability of the Form 300A data reported to OSHA, the agency will generate a random sample of establishments with low DART rates, using the CY 2021 data. <br></li></ul><li>Non-Responders: <br></li><ul><li>OSHA will generate a random sample of establishments that failed to provide the required Form 300A data to OSHA CY 2021. Inclusion of these nonresponding employers is intended to discourage employers from not complying with their obligation to report injury and illness information to avoid inspection. </li></ul></ul></div><div><br></div><div><span style="font-size:11pt;">Because OSHA includes both high-rate and low-rate responders, it is in the company’s best interest to accurately keep injury and illness records. </span></div><div> </div><div style="text-decoration:underline;">Other businesses:<br><br></div><div>More and more often, prospective clients, buyers, partners, and subcontractors are asking for or looking at DART rate data to assess the company’s safety program. In short, your DART rate can affect your reputation for safety in the community. </div><div> </div><div style="text-decoration:underline;">Insurers:<br></div><div><br></div><div>Your DART rates may be requested by an insurance carrier and affect the premiums on your workers compensation or other insurance policies. </div><div><br></div><div><span style="font-size:11pt;">OSHA is increasingly focused on recording workplace injuries and has now required that the data be uploaded to OSHA’s ITA. Since this information is now readily accessible to OSHA and the public, it could have far-reaching effects and should be maintained accurately with attention to detail. OSHA has provided a list of <a href="https://www.osha.gov/injuryreporting/faqs" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">FAQs</a> pertaining to its ITA. </span></div><div><br></div><div style="text-decoration:underline;"><span style="font-size:11pt;"><strong>OSHA ITA Submittal Resources:</strong></span></div><div><br></div><div><ul><li><a href="https://www.osha.gov/recordkeeping/naics-codes-electronic-submission" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Recordkeeping - Establishments in the following industries with 20 to 249 employees must submit injury and illness summary (Form 300A) data to OSHA electronically | Occupational Safety and Health Administration </a><br><br></li><li><a href="https://www.osha.gov/itareportapp" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">ITA Coverage Application </a><br><br></li><li><a href="https://www.osha.gov/injuryreporting/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Injury Tracking Application website </a><br></li></ul></div><p></p><table class="Table Ltr TableWordWrap SCXW115462116 BCX8" border="1" data-tablestyle="MsoTableGrid" data-tablelook="1184" aria-rowcount="7" style="margin:0px auto;padding:0px;table-layout:fixed;width:0px;empty-cells:show;overflow:visible;color:#000000;font-family:"segoe ui", "segoe ui web", arial, verdana, sans-serif;font-size:12px;background:transparent;border-spacing:0px;"><tbody class="SCXW115462116 BCX8" style="margin:0px;padding:0px;"><tr class="TableRow SCXW115462116 BCX8" role="row" aria-rowindex="1" style="margin:0px;padding:0px;overflow:visible;height:26px;"><td class="FirstRow FirstCol LastCol SCXW115462116 BCX8" role="rowheader" data-celllook="65536" colspan="4" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:437px;"><div class="TableHoverRowHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;height:10px;width:15px;cursor:pointer;display:flex;overflow:visible;z-index:5;bottom:-5.5px;left:-11.5px;"></div><div class="TableHoverColumnHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;cursor:pointer;display:inline-block;height:12px;left:auto;overflow:visible;text-align:center;top:-8.5px;width:20px;z-index:4;right:-10.5px;"><br></div><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">Quick Reference ITA Coverage Table*</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> </span></p></div></div></td></tr><tr class="TableRow SCXW115462116 BCX8" role="row" aria-rowindex="2" style="margin:0px;padding:0px;overflow:visible;height:16px;"><td class="FirstCol AdvancedProofingLightMode ContextualSpellingLightMode SpellingErrorLightMode SimilarityReviewedDarkMode SimilarityUnreviewedLightMode AddInCritiqueRedLightMode AddInCritiqueGreenLightMode AddInCritiqueBlueLightMode AddInCritiqueLavenderLightMode AddInCritiqueBerryLightMode HighContrastShading SCXW115462116 BCX8" role="rowheader" data-celllook="65536" rowspan="2" colspan="1" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:#e8e8e8;background-clip:padding-box;border:1px solid;width:137px;"><div class="TableHoverRowHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;height:10px;width:15px;cursor:pointer;display:flex;overflow:visible;z-index:5;bottom:-5.5px;left:-11.5px;"></div><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;"><span class="ms-rteFontSize-1"><span data-contrast="none" lang="EN-US" class="TextRun Underlined SCXW115462116 BCX8 ms-rteFontSize-1" style="margin:0px;padding:0px;color:#e97132;text-decoration-line:underline;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;"><span class="NormalTextRun SCXW115462116 BCX8 ms-rteFontSize-1" style="margin:0px;padding:0px;">Requirements:</span></span><span class="EOP SCXW115462116 BCX8 ms-rteFontSize-1" data-ccp-props="{"201341983":0,"335559740":259}" style="margin:0px;padding:0px;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#e97132;"> </span></span></p></div></div></td><td class="LastCol AdvancedProofingLightMode ContextualSpellingLightMode SpellingErrorLightMode SimilarityReviewedDarkMode SimilarityUnreviewedLightMode AddInCritiqueRedLightMode AddInCritiqueGreenLightMode AddInCritiqueBlueLightMode AddInCritiqueLavenderLightMode AddInCritiqueBerryLightMode HighContrastShading SCXW115462116 BCX8" data-celllook="65536" colspan="3" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:#c1e4f5;background-clip:padding-box;border:1px solid;width:299px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;color:windowtext !important;"><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">Peak </span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;"># of </span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">e</span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">mployees</span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;"> during the year</span></span><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:windowtext !important;"> </span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> </span></p></div></div></td></tr><tr class="TableRow SCXW115462116 BCX8" role="row" aria-rowindex="3" style="margin:0px;padding:0px;overflow:visible;height:9px;"><td class="AdvancedProofingLightMode ContextualSpellingLightMode SpellingErrorLightMode SimilarityReviewedDarkMode SimilarityUnreviewedLightMode AddInCritiqueRedLightMode AddInCritiqueGreenLightMode AddInCritiqueBlueLightMode AddInCritiqueLavenderLightMode AddInCritiqueBerryLightMode HighContrastShading SCXW115462116 BCX8" data-celllook="65536" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:#c1e4f5;background-clip:padding-box;border:1px solid;width:109px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;color:windowtext !important;">11 - 19</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> </span></p></div></div></td><td class="AdvancedProofingLightMode ContextualSpellingLightMode SpellingErrorLightMode SimilarityReviewedDarkMode SimilarityUnreviewedLightMode AddInCritiqueRedLightMode AddInCritiqueGreenLightMode AddInCritiqueBlueLightMode AddInCritiqueLavenderLightMode AddInCritiqueBerryLightMode HighContrastShading SCXW115462116 BCX8" data-celllook="65536" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:#c1e4f5;background-clip:padding-box;border:1px solid;width:92px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;color:windowtext !important;"><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">20 </span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">-</span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;"> 99</span></span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> </span></p></div></div></td><td class="LastCol AdvancedProofingLightMode ContextualSpellingLightMode SpellingErrorLightMode SimilarityReviewedDarkMode SimilarityUnreviewedLightMode AddInCritiqueRedLightMode AddInCritiqueGreenLightMode AddInCritiqueBlueLightMode AddInCritiqueLavenderLightMode AddInCritiqueBerryLightMode HighContrastShading SCXW115462116 BCX8" data-celllook="65536" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:#c1e4f5;background-clip:padding-box;border:1px solid;width:97px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;color:windowtext !important;"><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">100 or</span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;"> more</span></span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> </span></p></div></div></td></tr><tr class="TableRow SCXW115462116 BCX8" role="row" aria-rowindex="4" style="margin:0px;padding:0px;overflow:visible;height:42px;"><td class="FirstCol SCXW115462116 BCX8" role="rowheader" data-celllook="65536" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:137px;"><div class="TableHoverRowHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;height:10px;width:15px;cursor:pointer;display:flex;overflow:visible;z-index:5;bottom:-5.5px;left:-11.5px;"></div><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">Maintain OSHA records </span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#e97132;"> </span></p></div></div></td><td data-celllook="0" class="SCXW115462116 BCX8" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:109px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">Yes</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#e97132;"> </span></p></div></div></td><td data-celllook="0" class="SCXW115462116 BCX8" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:92px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">Yes</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#e97132;"> </span></p></div></div></td><td class="LastCol SCXW115462116 BCX8" data-celllook="0" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:97px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">Yes</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#e97132;"> </span></p></div></div></td></tr><tr class="TableRow SCXW115462116 BCX8" role="row" aria-rowindex="5" style="margin:0px;padding:0px;overflow:visible;height:44px;"><td class="FirstCol SCXW115462116 BCX8" role="rowheader" data-celllook="65792" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:137px;"><div class="TableHoverRowHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;height:10px;width:15px;cursor:pointer;display:flex;overflow:visible;z-index:5;bottom:-5.5px;left:-11.5px;"></div><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">Submit </span><a href="https://www.osha.gov/recordkeeping/naics-codes-electronic-submission" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><span><span data-contrast="none" lang="EN-US" class="TextRun Underlined SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#0000ff;font-size:11pt;text-decoration-line:underline;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;"><span class="NormalTextRun SCXW115462116 BCX8" data-ccp-charstyle="Hyperlink" style="margin:0px;padding:0px;">300A data</span></span></span></a> <span data-contrast="none" lang="EN-US" class="TextRun Underlined SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#0000ff;font-size:11pt;text-decoration-line:underline;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;"></span><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">to ITA</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#e97132;"> </span></p></div></div></td><td data-celllook="256" class="SCXW115462116 BCX8" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:109px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#7f7f7f;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">No</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#7f7f7f;"> </span></p></div></div></td><td data-celllook="256" class="SCXW115462116 BCX8" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:92px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">Yes</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#e97132;"> </span></p></div></div></td><td class="LastCol SCXW115462116 BCX8" data-celllook="256" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:97px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">Yes</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#e97132;"> </span></p></div></div></td></tr><tr class="TableRow SCXW115462116 BCX8" role="row" aria-rowindex="6" style="margin:0px;padding:0px;overflow:visible;height:50px;"><td class="FirstCol SCXW115462116 BCX8" role="rowheader" data-celllook="65792" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:137px;"><div class="TableHoverRowHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;height:10px;width:15px;cursor:pointer;display:flex;overflow:visible;z-index:5;bottom:-5.5px;left:-11.5px;"></div><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">Submit </span><a href="https://www.osha.gov/sites/default/files/appendix_b_to_subpart_e_of_part_1904.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><span><span data-contrast="none" lang="EN-US" class="TextRun Underlined SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#0000ff;font-size:11pt;text-decoration-line:underline;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;"><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">300 and 301 data</span></span></span><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;"> </span></a><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">to ITA</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#e97132;"> </span></p></div></div></td><td data-celllook="256" class="SCXW115462116 BCX8" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:109px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#7f7f7f;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">No</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#7f7f7f;"> </span></p></div></div></td><td data-celllook="256" class="SCXW115462116 BCX8" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:92px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#7f7f7f;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">No</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#7f7f7f;"> </span></p></div></div></td><td class="LastCol SCXW115462116 BCX8" data-celllook="256" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:97px;"><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;text-align:center;"><span data-contrast="none" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;color:#e97132;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">Yes</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335551550":2,"335551620":2,"335559740":259}" style="margin:0px;padding:0px;font-size:11pt;line-height:18.3458px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;color:#e97132;"> </span></p></div></div></td></tr><tr class="TableRow SCXW115462116 BCX8" role="row" aria-rowindex="7" style="margin:0px;padding:0px;overflow:visible;height:50px;"><td class="FirstCol LastCol LastRow SCXW115462116 BCX8" role="rowheader" data-celllook="69888" colspan="4" style="margin:0px;padding:0px;overflow:visible;vertical-align:middle;background-color:transparent;background-clip:padding-box;border:1px solid;width:437px;"><div class="TableHoverRowHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;height:10px;width:15px;cursor:pointer;display:flex;overflow:visible;z-index:5;bottom:-5.5px;left:-11.5px;"></div><div class="TableCellLeftBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;cursor:pointer;overflow:visible;width:7px;z-index:1;left:-4px;top:-0.5px;"></div><div class="TableCellTopBorderHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:1;cursor:pointer;left:-0.5px;top:-4px;"></div><div class="TableColumnResizeHandle SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat;bottom:0px;overflow:visible;top:-0.5px;width:7px;z-index:3;right:-4px;"></div><div class="TableInsertRowGapBlank SCXW115462116 BCX8" style="margin:-3px 0px 0px;padding:0px;background-color:transparent;background-repeat:repeat;height:7px;overflow:visible;z-index:3;left:-0.5px;bottom:-4px;"></div><div class="TableCellContent SCXW115462116 BCX8" style="margin:0px;padding:0px 7px;overflow:visible;"><div class="OutlineElement Ltr SCXW115462116 BCX8" style="margin:0px;padding:0px;clear:both;cursor:text;overflow:visible;direction:ltr;"><p class="Paragraph SCXW115462116 BCX8" style="margin-bottom:0px;padding:0px;vertical-align:baseline;background-color:transparent;color:windowtext;"><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;font-size:10pt;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;"><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">*</span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">This table applies to</span></span><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;font-size:10pt;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> </span><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;font-size:10pt;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">NAICS codes:</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335559740":259}" style="margin:0px;padding:0px;font-size:10pt;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> </span></p><ul><li><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">6231 - </span><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">Nursing Care </span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">Facilities;</span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;"> </span></span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335559740":259}" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> </span></li><li><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;"><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">6232 </span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat-x;background-position:left bottom;">- </span></span><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW115462116 BCX8" style="margin:0px;padding:0px;background-repeat:repeat-x;background-position:left bottom;">Residential</span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;"> Intellectual and Developmental Disability, Mental Health, and Substance Abuse Facilities; </span></span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335559740":259}" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> </span></li><li><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">6233 -</span><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;"> Continuing Care Retirement Communities and Assisted Living Facilities for the </span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;">Elderly;</span><span class="NormalTextRun SCXW115462116 BCX8" style="margin:0px;padding:0px;"> </span></span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335559740":259}" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> </span></li><li><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;font-weight:bold;">6239 -</span><span data-contrast="auto" lang="EN-US" class="TextRun SCXW115462116 BCX8" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> Other Residential Care Facilities</span><span class="EOP SCXW115462116 BCX8" data-ccp-props="{"201341983":0,"335559740":259}" style="background-color:transparent;color:windowtext;font-size:10pt;margin:0px;padding:0px;line-height:17.2667px;font-family:aptos, aptos_embeddedfont, aptos_msfontservice, sans-serif;"> </span></li></ul></div></div></td></tr></tbody></table><p><br></p> | The OSHA Standard 1904.41 requires certain employers to comply with electronic submission of workplace injuries and illnesses. | |
Ergonomics 201: Controls, State Regulations, and Resources | https://publish.ahcancal.org/News-and-Communications/Blog/Pages/Ergonomics-201-Controls-State-Regulations-and-Resources.aspx | Ergonomics 201: Controls, State Regulations, and Resources | | | | | 3/6/2024 5:00:00 AM | | <p><br><br></p><div>In a <a href="/News-and-Communications/Blog/Pages/Safe-Resident-Handling-and-Prevention-of-Musculoskeletal-Injuries-Ergonomics-in-Long-Term-Care-Communities.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">previous blog post</a>, the basic OSHA requirements, or expectations, for prevention of musculoskeletal injuries in long term care (LTC) employees were reviewed. As previously stated, Federal OSHA does not have a specific standard dedicated to preventing sprains and strains—often referred to as "ergonomics" by OSHA. Instead, OSHA regulates ergonomic concerns through the <a href="https://www.osha.gov/laws-regs/oshact/section5-duties" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">General Duty Clause</a>, which requires employers to provide a workplace free from recognized hazards that are likely to cause death or serious physical harm to employees. Importantly, individual states have also issued regulations to address safe patient handling and ergonomics. This post highlights certain controls or interventions that OSHA is likely to expect at a LTC facility, identify resources that may be helpful when implementing or updating a safe patient handling program, and list relevant state regulations. </div><div><br></div><div><span style="font-size:11pt;"><strong>Common Controls </strong></span></div><div><span style="font-size:11pt;"><br></span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">When talking about employee health and safety, "controls" are the precautions or interventions taken by the employer to reduce the likelihood of an injury or illness. As <a href="/News-and-Communications/Blog/Pages/Personal-Protective-Equipment-Hazard-Assessment-Standard-and-the-Hierarchy-of-Controls.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">previously discussed</a>, OSHA regards employee safety in terms of a hierarchy of controls, which moves from the most desirable (elimination) to least desirable but still effective (PPE). </span></div></blockquote><div style="text-align:center;"><img src="/News-and-Communications/Blog/PublishingImages/Pages/Ergonomics-201-Controls-State-Regulations-and-Resources/Hierarchy.jpg" alt="Hierarchy.jpg" style="margin:5px;" /><br></div><div> <br></div><div><br></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">When assessing hazards that might contribute to musculoskeletal injuries and identifying the controls that could minimize those injuries, it can be helpful to consider the entire hierarchy, including the following potential controls: </span></div></blockquote><div><br></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;text-decoration:underline;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">Elimination, Substitution, and Engineering:</span></div></blockquote></blockquote><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">The lines betw</span><span style="font-size:11pt;">een these three levels are blurred, but regardless of what you call it, LTC communities use several strategies to eliminate, substitute, or engineer around patient handling hazards. Initially, LTC communities were built to accommodate wheelchairs and similar resident transportation, reducing the frequency of resident transfers. Moreover, communities typically use a range of assistive devices to reduce or eliminate the amount of lifting done by staff. These devices include mechanical lifts, transfer boards, gait belts, and grab bars. </span></div></blockquote></blockquote></blockquote><div><br></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;text-decoration:underline;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">Administrative:</span></div></blockquote></blockquote><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">One of the most significant advantages LTC communities tend to have related to ergonomics is the early implementation of individualized care plans to identify residents who present a hazard to themselves or employees when being lifted or transferred. These care plans are an important hazard assessment tool, but they can also be considered an administrative control used to reduce the occurrence of musculoskeletal injuries. </span></div></blockquote></blockquote></blockquote><div><br></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;text-decoration:underline;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">Work Practice:</span></div></blockquote></blockquote><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">How an employee lifts or transfers a resident is a work practice control developed by training on proper lifting techniques, body mechanics, and assistive</span><span style="font-size:11pt;"> devices. After an employee is trained, they should be monitored for using proper methods and re-trained or disciplined if they continue to use proper methods. </span></div></blockquote></blockquote></blockquote><div><br></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;text-decoration:underline;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">PPE:</span></div></blockquote></blockquote><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:11pt;">Back braces are typically available to staff to reduce the likelihood of back injuries. If back braces are made available, employees should be informed on how to request a brace and trained on how to use it properly. </span></div></blockquote></blockquote></blockquote><div><br></div><div><span style="font-size:11pt;"><strong>Relative State Plan Regulations and Emphasis Programs </strong></span></div><div><br></div><div><span style="font-size:11pt;">While Federal OSHA does not have a specific regulatory standard for safe patient handling, it is important for LTC centers under <a href="https://www.osha.gov/stateplans" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">OSHA approved State Plans</a> to review their state programs for any specific requirements. LTC centers should also be aware of active emphasis programs. </span></div><div><br></div><div style="text-decoration:underline;"><span style="font-size:11pt;">Relative State Requirements:</span></div><div><ul><li><span style="font-size:11pt;"><span style="text-decoration:underline;">California</span> - Has a Repetitive Motion Injuries <a href="https://www.dir.ca.gov/title8/5110.html" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">standard</a> that applies to any job, process, or operation with more than one confirmed recordable injury from repetitive motion. </span></li><li><span style="font-size:11pt;"><span style="text-decoration:underline;">Minnesota</span> - Requires a safe patient handling <a href="https://www.revisor.mn.gov/statutes/cite/182.6553" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">program</a>. </span></li></ul></div><div><br></div><div style="text-decoration:underline;"><span style="font-size:11pt;">Recent Emphasis Programs</span></div><div><ul><li><span style="font-size:11pt;">New Mexico – <a href="https://www.env.nm.gov/wp-content/uploads/sites/18/2021/01/21-06-Hospitals-and-Nursing.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Special Emphasis Program - Hospitals, Nursing and Residential Care Communities </a></span></li><li><span style="font-size:11pt;">North Carolina – <a href="https://www.labor.nc.gov/long-term-care-special-emphasis-program" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Long Term Care Special Emphasis Program</a> </span></li><li><span style="font-size:11pt;">Oregon - <a href="https://osha.oregon.gov/OSHARules/pd/pd-284.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Local Emphasis Program (LEP)</a> </span></li></ul></div><div><br></div><div><span style="font-size:11pt;">AHCA/NCAL’s <a href="/Survey-Regulatory-Legal/Documents/A%20Roadmap%20to%20OSHA%20Requirements.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">OSHA Roadmap</a> resource also contains details on state plans that can be referenced. </span></div><div><br><span style="font-size:11pt;">Ergonomics and safe patient handling are critical elements to an effective safety program in the LTC sector. While only some LTC centers have specific state requirements to meet, employees and residents of all communities greatly benefit when effective hazard assessments and control measures are implemented. </span><br></div><div><br></div><div><span style="font-size:11pt;"><strong>Resources </strong></span></div><div><ul><li><span style="font-size:11pt;"><a href="https://www.osha.gov/ergonomics/control-hazards" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">OSHA Ergonomics page </a></span></li><li>OSHA Publications <br></li><ul><li><a href="https://www.osha.gov/sites/default/files/publications/OSHA3708.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Safe Patient Handling - Preventing Musculoskeletal Disorders in Nursing Homes</a></li><li> <a href="https://www.osha.gov/sites/default/files/publications/final_nh_guidelines.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Guidelines for Nursing Homes - Ergonomics for Prevention of MSDs </a></li></ul><li><span style="font-size:11pt;">OSHA eTool for hospitals (including material relevant to LTC communities - <a href="https://www.osha.gov/etools/hospitals/hospital-wide-hazards/work-related-musculoskeletal-disorders" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Work-related Musculoskeletal Disorders </a></span></li><li><span style="font-size:11pt;"><a href="https://www.cdc.gov/niosh/topics/safepatient/default.html" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">NIOSH Safe Patient Handling and Mobility </a></span></li></ul></div><p><br></p> | In a previous blog post, the basic OSHA requirements, or expectations, for prevention of musculoskeletal injuries in long term care employees were reviewed. | |