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  • Writer's pictureStephanie Darden

The Hidden Costs of Not Addressing Chemotherapy Safe Handling Issues.

OSHA lists hospitals as one of the most hazardous places to work in (1). Hospitals have a higher likelihood of injury and illness resulting in days away from work beating out other industries like construction and manufacturing. OSHA's regulations protect your staff from the hazards found in the hospital like chemotherapy.

Healthcare organizations that do not follow chemotherapy safe handling regulations are at increased risk for several financial losses.

These are some of the hidden costs that are affecting your organization’s bottom line.

1. OSHA Penalty Violations range between $14,500-$145,000 per violation (2).

Per OSHA regulations, all healthcare organizations who employ staff that handle hazardous drugs like chemotherapy must have a Hazard Communication Standard (3). In 2021, the #4 Serious OSHA Violation is Hazard Communication (4).

Healthcare organizations that employ staff that handle hazardous substances like chemotherapy must follow OSHA regulations to protect staff. A Hazard Communication Program contains information on (3):

  1. Maintaining Safety Data Sheets for each chemotherapy that are accessible for staff

  2. Staff must have initial training prior to handling hazardous drugs

  3. Staff competency must be reviewed on a regular basis

  4. Staff must have adequate PPE to administer chemotherapy safely

  5. Staff must be informed in writing their reproductive risks when handling chemotherapy

Organizations that do not have a Hazard Communication Program in place can face hefty fines. One OSHA Violation costs $14,500. For every day the violation was not corrected after the deadline is $14,500 per day. For repeat violations, healthcare organizations can pay upwards of $145,000 (2).

Having a Hazard Communication Program can benefit healthcare organizations in two critical ways: It can prevent OSHA violation fines and it can reduce an organization’s OSHA fines up to 70% (5).

2. Loss of accreditation and funding

OSHA is a federal regulatory body that most U.S organizations must comply with. Healthcare organizations that receive Medicare and Medical funding must comply with federal regulations or they risk losing funding from the Centers for Medicare and Medicaid Services (CMS) (6).

Having accreditation is important for healthcare organizations because it builds patient trust as it is an indicator of high quality patient care. Healthcare organizations that are also accredited by federal agencies must follow federal guidelines. For example, infusion clinics that have the federal Ambulatory Care Accreditation by the Accreditation Commission for Health Care (ACHC) must follow federal regulations like OSHA. Infusion clinics having OSHA violations puts them at risk for losing accreditation and funding. Make sure to protect the accreditation your organization worked hard for.

3. Decreased Billable Insurance Revenue.

Ambulatory outpatient services, like infusion clinics, are highly profitable to hospitals. Infusion clinics are high revenue clinics as a single 30-minute intravenous antibody infusion brings an average of $30,000 revenue to the clinic.

Each chemotherapy and biotherapy trained nurse on average gives about 4 antibody treatments per day in an infusion clinic. If one nurse calls in sick because of symptoms relating to a chemotherapy exposure, the clinic lost $120,000 in potential billable insurance reimbursement revenue that one day.

Not addressing chemotherapy safe handling issues not only affects the safety of your staff, but also affects your organization’s bottom line. Protect your healthcare organization by making sure you have a Hazard Communication Program, follow federal guidelines if you receive Medicare insurance reimbursement, and track your organization’s loss of potential revenue.

Questions to address in your organization:

  • Does your organization have a Hazard Communication Program in place? Are staff informed of your Hazard Communication Program?

  • Are you doing all that you can to protect your organization's accreditation?

  • How much potential revenue loss because of sick calls?


  1. Worker safety in hospitals. OSHA.

  2. OSHA Penalties. OSHA.

  3. OSHA Regulations. OSHA.

  4. Top 10 Frequently Cited Standards. OSHA.

  5. Chapter 6: Penalties and Debt Collection. OSHA.

  6. Quality, Safety, and Oversight- Certification and Compliance. CMS.



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