TMC Industry Updates

October 10, 2013

One of TMC’s Clients, Dr. Patrick McGuire’s Staff & Patients, Support Area Youth 

Jackson Co. (September 17, 2013)  –  The staff and patients Dr. Patrick McGuire, DDS of Sylva, NC collected needed items for area youth served by Barium Springs. Then during a day of service several staff members made mini –totes for the children and teens served by Barium Springs. “I really appreciate that they reached out to us and wanted to help” Autumn Weil, Regional Development Officer for Barium Springs, stated. She explains that a lot of times kids come into Barium Springs’ runaway/homeless youth shelter, Hawthorn Heights, or their foster homes without anything except the clothes on their backs. Barium Springs provides them with all the necessities including hygiene items, school supplies, and bedding. 

Would you like to help? Barium Springs is currently looking for sponsors for their Christmas Angel Program for the holiday season. This program ensures that area youth receive gifts and necessities at Christmas. Please contact Autumn Weil for details at 

About Barium Springs: Barium Springs is a non-profit agency serving 41 counties in NC, including the entire western North Carolina area. Barium Springs’ three main objectives in Western NC are to heal the hurt for children and teens who have been abused, neglected or who are troubled; provide a safe home through foster care, adoption, and Hawthorn Heights; and encourage a healthy start through intervention and prevention services. In 2012, Barium Springs served 750 individuals, families and children in Western North Carolina. Visit or call Autumn Weil at (828) 231 – 5413 to learn more about ways to partner with Barium Springs.


September 23, 2013

First Case of Patient to Patient Transfer of Hepatitis C in Dental Environment

This week health officials in Tulsa, Ok announced the interim status report on results of the public health investigation of a dental surgical practice. In March, more than 7,000 individuals were notified of the need for hepatitis b and c, and HIV testing as they may have been exposed to bloodborne viruses at this practice. According to updates by health officials, the Oklahoma Public Health Laboratory completed testing for 4,202 persons. Eighty-nine patients tested positive for hepatitis C, 5 for hepatitis B, and 4 for HIV.  An unknown number of persons also sought testing through their private health care provider. The estimated cost thus far for the investigation and testing is more than $710.000.

The report goes on to say:
Findings of the epidemiological investigation of former patients testing positive for hepatitis C indicate that one event of patient-to-patient transmission of hepatitis C virus occurred in the practice. Genetic-based testing of patient specimens by the Centers for Disease Control and Prevention (CDC) provided laboratory confirmation of this finding.
“This is the first documented report of patient-to-patient transmission of hepatitis C virus associated with a dental setting in the United States,” said State Epidemiologist Dr. Kristy Bradley. “While dental procedures are generally safe, this reinforces the importance of adhering to strict infection control procedures in dental settings.”   

The investigation which led to the testing of the individuals identified many gaps in infection control standards including the lack of spore testing  which is critical to monitor the sterilization process, use of instrumentation which was rusty, and injection safety errors.

Infection control is the baseline for safe care in any health care environment, as well as a very important component of a safe workplace. Some basic considerations when evaluating your office environment include the following:

  • Are standard OSHA and infection control precautions and procedures observed with every patient?
  • Is PPE utilized based on the task being performed? In most dental procedures, workers should wear a mask, goggles which are impact resistant, a cover gown which is long sleeved, buttons to the neck and covers the lap when sitting, and gloves. Gloves and masks must be discarded after each patient encounter, goggles should be cleaned and disinfected, and if the cover gown is visibly soiled it should be replaced.
  • Are surfaces clean and disinfected after every patient encounter if barrier devices are not utilized?
  • Are all reusable instruments which touch the inside of the mouth cleaned, packaged and sterilized before reuse?
  • Is the sterilization process monitored by the use of internal and external indicators in every package and spore testing every 5 days of use of the unit as recommended by the CDC?
  • Are single use items discarded after being utilized on one patient for one procedure?

While this incident is extremely rare, it does provide ALL healthcare workers the opportunity to pause and take stock of their infection control processes. You can have a safe environment for both patients and workers.

For additional information:

TMC Infection Control Training for Dental Practices

The Advisor – Each monthly edition provides an infection control update

CDC Dental Infection Control Guidelines

OSAP Hepatitis C Toolkit

May 31, 2013

News Flash!  Our very own Karen Gregory is a “Super Volunteer”
Charlotte ‘super’ volunteer focuses on the patient
Read more here:

March 8, 2013

News Flash!     Updated FMLA Posting Requirement is March 8th

For those of you who have 50 or more employees, you need to know that the Department of Labor recently amended the Family and Medical Leave Act (FMLA) to help protect family members of current military service members and veterans.  This extends the right of eligible employees to attend to personal matters and medical needs related to their family members’ service.
The effective date of the final rule is March 8, 2013 which means covered employers need to display the updated poster by that date.  
TMC consultants will, as always, assist you with meeting this posting requirement when on-site. 
In the interim, click here to download and print at no charge.  

March 1, 2013

While we will provide further detail in a later publication on the updated requirements of a compliant agreement, please note that if a Business Associate Agreement (BAA)was not in place on January 25, 2013, a BAA must be obtained no later than September 23, 2013.
Business Associates and their subcontractors will now be held to the same standards as covered entities as it relates to enforcements and fines. HITECH requires BAs to comply with all elements of the Security Rule if applicable to the services provided, and at a minimum use and disclosure standards outlined in the Privacy Rule.
What actions need to be taken? 

  • Medical and dental practices ensure you have a complete listing of all service providers who qualify as a business associate. 
  • Business associates, begin compiling a listing of subcontractors meeting the updated definition.

    Here is a sample BAA that has been provided by Health and Human Services.

January 25, 2013
Update on Regulatory Changes – HIPAA Omnibus Final Rule Is Published and the Hazard Communication Standard Update Read Article

Also check out our FREE webinar  for TMC HIPAA clients on this new ruling for HIPAA

Hazard Communication Standard Updated

Reflects Globally Harmonized System of Classification and Labeling of Chemicals

For several years articles have been published, blogs have been posted, conversations have occurred about GHS or Globally Harmonized System and the update of the Hazard Communication Standard (HCS). The much anticipated update of the Standard occurred on March 26, 2012 when the US Department of Labor published the final rule. And while this rule will impact the healthcare industry, take a deep breath and relax; changes will not occur immediately.

The Globally Harmonized System (GHS), which is a United Nation’s document, is an international approach to hazard communication. These recommendations were used by OSHA to establish mandatory requirements for hazard communication. According to information found on the OSHA website the primary benefit of the update to the regulation is to provide a standardized approach to hazard classification, labels and safety data of chemicals. In simple words, a single set of criteria will be used to classify chemicals according to outlined health and physical hazards through-out the world. Additionally material safety data sheets, which will now be referred to as safety data sheets, will all follow a standardized format and labels will include, among other things, a pictogram reflecting the hazard and precautionary statements. It is believed that consistent communication of risks associated with the use of hazardous chemicals will create a safer work environment for all involved.

What Happens Now?

In order to begin the process of harmonization, chemicals must be evaluated based on specific criteria to identify health and physical hazards. Once the hazards have been identified, the chemicals will be appropriately labeled based on the updated standard and safety data sheets will be created in a consistent format. This information will be provided to customers utilizing the hazardous chemicals.

Eventually all employers having hazardous chemicals in their workplace must have the chemicals appropriately labeled and they must obtain a Safety Data Sheet for each item. Appropriate employee training based on the classification will be required for chemicals in use.

Out-patient facilities will notice the most change in the following two areas:

Safety Data Sheets – Previously Material Safety Data Sheets

SDS will include information on the hazards associated with a particular chemical. The new SDS will be created by the chemical manufacturer and will be supplied to users when the updates are complete. Each SDS must contain the following information in the same order for consistency and ease of use.

Section 1. Identification
Section 2. Hazard(s) identification
Section 3. Composition/information on ingredients
Section 4. First-Aid measures
Section 5. Fire-fighting measures
Section 6. Accidental release measures
Section 7. Handling and storage
Section 8. Exposure controls/personal protection
Section 9. Physical and chemical properties
Section 10. Stability and reactivity
Section 11. Toxicological information
Section 12. Ecological information
Section 13. Disposal considerations
Section 14. Transport information
Section 15. Regulatory information
Section 16. Other information, including date of preparation or last revision

As you begin to receive the updated SDS remember to archive, not discard, the outdated MSDS.* Sections 12-15 may be included in the SDS, but are not required by OSHA.


Labels will require the following elements:

  • Pictogram: Symbol on a white background within a red diamond which will convey specific information about the hazard. There will be a total of eight different pictograms.
  • Signal words: Single word use to relate the severity of the hazard. Danger (more severe hazard) and warning are the words which will be utilized.
  • Hazard Statement: Statement describing the nature of the hazard(s) of a chemical. This may include the degree of the hazard.
  • Precautionary Statement: Phrase(s) describing measures to minimize or prevent adverse effects when handling the chemical.

Important Dates

  • December 1, 2013 – Employers must train employees on the new label elements and safety data sheet (SDS) format. Employee training by this date is needed as it is possible facilities will begin to receive SDS and chemicals with the updated labeling within a short time frame.
  • June 1, 2016 – Workplace labeling and update of the hazardous communication plan, as well as any additional training must be completed by employers.


Yes, there are items which must change in your practice as a result of this regulatory update, but the timeline allows a very generous amount of time to come into compliance with the standard. The good news for TMC clients is we have begun planning on how to update the chemical labels, which are in place in your practice, once the information becomes available. Stay tuned, there is much more to come as details are shared on how to comply with these new regulations. TMC is your partner as you work toward compliance with the updated Hazard Communications Standard!

For TMC’s eMSDS clients: These changes to your eBinder will happen automatically as new SDS become available from your manufacturer! If you wish to learn more about TMC’s eMSDS Program, please contact our Client Services team to find out how we can make your hazard documentation a snap!