Long Term Care

Long term care covers a variety of services to meet the health and personal needs of people who cannot fully care for themselves for a short or long period of time.

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What are the hazards associated with long term care?

The major hazards to which employees in long term care facilities are potentially exposed are: bloodborne pathogens; tuberculosis; slips, trips and falls; ergonomic stressors (especially back injury); and workplace violence.

Exposure to bloodborne pathogens can occur when providing medical assistance, including first aid, or during housekeeping activities when blood is or may be present, such as disposing of contaminated needles.

Occupational exposure to tuberculosis can occur when a resident with active tuberculosis is not properly assessed before being admitted to the facility.

Slips, trips and falls can occur when staff traverse corridors with wet or slippery floors.

Finally, workplace violence is a constant risk for staff when dealing with residents who may have some level of mental impairment (e.g., due to dementia) or when dealing with family members of residents.

Is there a special emphasis program associated with this topic?

Occupational exposure to bloodborne pathogens, tuberculosis, slips, trips and falls, and workplace violence in long term care facilities falls with the OSH Division long term care special emphasis program.

What can I do to protect myself?

Gloves and other necessary personal protective equipment must be provided by the employer and worn when providing medical assistance where the presence of blood and other potentially infectious materials (OPIM) are present or can reasonably be expected to be present. Accordingly, universal precautions should always be followed when providing first aid.

Slip-resistant shoes should be worn when working in areas having slippery or wet floors. Be sure to use proper patient handling techniques, especially the use of patient lifting devices, when moving residents from their beds or when assisting them into and out of bed.

In addition, using safety data sheets to become familiar with the hazards of chemicals you may be required to use along with wearing the appropriate personal protective equipment. 

What resources are available to assist employers?

Safety and Health Programs

Example programs for bloodborne pathogens, personal protective equipment (PPE), respiratory protection, and hazard communication are available and should be adapted to the conditions of each particular workplace. Federal OSHA also has workplace violence prevention programs that can be used as a resource.

Training and Outreach Services

Presentations on bloodborne pathogens, personal protective equipment (PPE), respiratory protection, hazard communication and tuberculosis are available to assist employers in training their employees and should be modified to address site-specific hazards and conditions.

In addition, the education, training and technical assistance bureau provides free online safety and health training and outreach services (i.e., speaker's bureau requests, safety booths) upon request. Oregon OSHA has a free on-line course for workplace violence prevention. 

Lastly, the NCDOL Library offers free safety and health videos (including streaming video services) and related research assistance on consensus standards (i.e., ANSI, NFPA, NEC).

A-Z Safety and Health Topics

A-Z topic pages on bloodborne pathogens, personal protective equipment, respiratory protection, hazard communication, tuberculosis, ergonomics, and workplace violence can provide more resource information. 

Consultation Services

The consultative services bureau provides free and confidential onsite consultation regarding worksite safety and health hazards.

Which standards apply?

OSH has adopted the following standards applicable to long term care facilities in North Carolina. Note: Please also check the standards information and activity webpage to see if there has been any recent or upcoming regulatory activity on this topic. 

General Industry


General Duty Clause

NCGS 95-129(1) - general duty clause

Other Applicable Standards

The Which OSHA Standards Apply webpage can also help identify other standards that may be applicable to your worksite.

Where can I learn more?

Industry Guides

Compliance Documents

Hazard Alerts

Hazard Alert 2150 - COVID-19: Review of Respiratory Protection for Long-Term Care Workers.

Technical Assistance

If you would like to receive interpretive guidance on this or any other OSH standard or topic, you can submit your questions using the Ask OSH web form, by e-mail to ask.osh@labor.nc.gov or by calling 919-707-7876.