Natchaug Hospital, a psychiatric facility in Mansfield, has been issued citations by the U.S. Occupational Safety and Health Administration for allegedly violating rules regarding respiratory protections for employees and failing to properly record eight cases of COVID-19 among staff.

The citations, based on inspections conducted between May 21 and Sept. 8, call for $13,494 in penalties and require the hospital to correct the alleged violations by Oct. 26. The hospital has until Oct. 5 to file notice that it intends to contest the citations, according to a U.S. Department of Labor spokesman.

Natchaug is part of the Hartford HealthCare network, which also includes Backus Hospital in Norwich and Windham Hospital.

Of the three citations issued, two pertain to personal protective equipment, or PPE, for employees and are deemed “serious.” One of them, carrying a penalty of $11,566, has to do with Natchaug’s alleged failure on March 18, April 25 “and on an on-going basis” to develop and implement "a written, work-site specific respiratory protection program" to address the use of N95 face masks, which were required to be worn by staff who could be exposed to the coronavirus.

The citation says staff members performed or assisted with COVID-19 “nose swab testing, which had been identified by the employer to be a procedure that could aerosolize droplets, which is believed to be the primary mode of transmission” of the disease without such a program in place.

Staff members also directly cared for patients suspected of being infected with COVID-19 and awaiting test results, the citation alleges.

The second serious violation stems from an alleged April 25 incident on the hospital’s adult unit in which employees caring for a patient suspected of having COVID-19 were not provided adequate respiratory protection and were potentially exposed to the disease. Employees were required to be within 6 feet of the patient, who was not wearing a mask.

“Appropriate respiratory protection is an N95 filtering facepiece,” the citation says.

In a May 12 incident on the hospital’s adolescent unit, employees who assisted with the admission and care of a patient suspected of having COVID-19 were not provided with N95s and were potentially exposed to the disease, the citation alleges.

The third citation, categorized as “Other-than-Serious” and carrying a $1,928 penalty, alleges the hospital failed to properly record work-related illnesses among employees, citing eight instances from March 16 to March 24 in which employees tested positive for COVID-19. The violation was corrected during an OSHA inspection, documents show.

Five employees who tested positive were registered nurses affiliated with Natchaug Hospital Unions United, AFT Connecticut Local 5052, according to Matt O'Connor, a union spokesman. Two other Natchaug nurses exhibited COVID-19 symptoms, one of whom tested negative and one of whom wasn't tested, O'Connor said.

The union represents about 80 registered nurses at Natchaug as well as about 120 therapists and educators.

“Hartford HealthCare executives should be responsible for ensuring its nurses and health professionals are properly equipped to provide safe patient care,” John Brady, AFT Connecticut's vice president, said in a statement. “OSHA’s citations are a step toward ensuring that is the case. It is unconscionable to direct (front-line) caregivers to fight COVID-19 without providing adequate protections. Allowing them to get sick or spread the virus is the height of irresponsibility.”

Asked for comment, Hartford HealthCare issued a statement attributed to Dr. Ajay Kumar, its chief clinical officer.

“While we are disappointed with these findings, our commitment to fighting this global pandemic, containing the spread of the virus and ensuring the safety of our colleagues and communities is unwavering,” he said. “Natchaug Hospital is a leading mental health and addiction services provider. Patients there rarely require medical assessments and medical care. When they do, they are typically sent to nearby hospitals which specialize in that type of care. As part of our ongoing efforts to promote safety and protection, Natchaug Hospital always had adequate supply of PPE.”

“We have fully implemented a respiratory protection program,” Kumar said.

AFT Connecticut filed an initial OSHA complaint in April, claiming that Natchaug staff who dealt with a patient suspected of having COVID-19 were not provided with PPE, including N95s and face shields. Nurses also claimed that patients who exhibited COVID-19 symptoms were not given masks and that staff were not provided with respiratory protection when caring for such patients.

They also said the hospital was running low on disinfectant wipes.

In a May 8 letter to an official in OSHA’s Hartford office, Thomas Mulhearn, Hartford HealthCare’s manager of occupational safety, offered a point-by-point rebuttal of the union’s complaint.

“Our investigation found that appropriate infection control procedures, including the provision of appropriate personal protective equipment ('PPE') are in place at Natchaug Hospital,” Mulhearn wrote. “... Natchaug Hospital has in place policies and procedures dictating when PPE is required to be donned, and the investigation found that the applicable policies and procedures were followed at all relevant times associated with this complaint.”

b.hallenbeck@theday.com