MultiCare plans appeal after urgent care clinic in Puyallup cited for COVID violations

PIERCE COUNTY, Wash. — A Tacoma health care system plans to appeal a citation it received from the state over COVID-19 safety violations after a November inspection.

The state Department of Labor & Industries on Feb. 19 issued a citation and notice of assessment to MultiCare following a COVID-19 safety inspection at its Indigo Urgent Care clinic at 15125 Meridian Ave. E., Suite 101 in Puyallup.

The citation carries fines totaling $28,400, which includes the one repeat serious violation, four serious violations and one general violation.

The “repeat serious” violation involved not providing employees “with a workplace free from recognized hazards that are causing or likely to cause serious injury or death …,” according to the document.

It noted social distancing “was not enforced and there was no barrier or other means of separation between employees while working at a distance of less than 6 feet. Upon inspection, no engineering controls to maintain social distancing between employees or patients were in place at the reception desk and between workers at the ‘pod’ group workstation in the back of the clinic where providers sit.”

Other violations involved lack of “appropriate respiratory protection” for workers and lack of enhanced cleaning of shared workspaces “after COVID-19 positive employees were identified,” according to the notice.

The News Tribune obtained a copy of the final citation from L&I this week.

MultiCare, in an emailed statement to The News Tribune on Thursday in response to questions, said it would appeal the action.

“We’re deeply disappointed by the decision to issue these citations about the safety practices we’ve employed throughout this pandemic and we plan to appeal them,” wrote Anna Agnew, director of external communications with the health system. “All MultiCare employees have the appropriate personal protective equipment (PPE) they need to do their jobs safely.

“Throughout the pandemic, we have worked quickly to ensure we were following the latest guidance and best practices outlined by DOH and the CDC – often amidst an unstable global PPE supply.”

Joe Crane, regional administrator for Union of American Physicians and Dentists, disputed MultiCare’s response.

“UAPD strongly disagrees that Multicare employees have had the appropriate PPE throughout this pandemic. UAPD members had to strike to achieve the minimum PPE,” Crane wrote The News Tribune on Thursday.


While the violations were in regard to the one site, the actions to address them apply to all Indigo facilities, according to Tim Church, media representative for L&I.

“They’re using the same business license for all of these places,” Church said Wednesday. “And so ... the entire company has to make sure (a violation) doesn’t exist because it is considered a citation for them. If we find it again, it’s considered a repeat (violation). They would face larger penalties.”

The department called on MultiCare to install barriers “everywhere in the clinics that employees are unable to maintain 6 feet of distance between themselves or patients (outside of direct patient care).”

Including the primary repeat serious violation, other violations as listed on the notice:

Serious violation: The employer did not select and provide appropriate respiratory protection for employees providing care to COVID-19 positive or rule-out patients.

Serious violation: The employer did not develop a worksite-specific written respiratory protection program.

Serious violation: The employer did not select a different respirator when the employee using the selected respirator failed the fit test.

Serious violation: The employer did not perform enhanced cleaning of shared workspaces after COVID-19 positive employees were identified.

General violation: Not all COVID-19 cases among employees were captured on the OSHA 300 log — used to identify injury trends and take action to prevent injuries from reoccurring. This carried no financial penalty amount.

Beyond installing protective barriers, the clinics were ordered to develop and submit a policy for both routine cleaning and deep cleaning after identifying a COVID-19 positive employee. They also must submit complete OSHA 300 logs as well as updated respiratory protection program with updated fit testing procedures for masks and respirators and “fit test records of all employees who provide direct patient care at the retail clinics,” according to the notice.


Agnew of MultiCare noted in the statement Thursday: “We think it’s important to highlight that the L&I citation for Indigo Urgent Care clinics is based on a November 2020 inspection, just days before we identified a reliable supplier for N95s and began to fit test and supply N95s to all our urgent care providers and staff.”

She added, “Our priorities have been and will remain to protect the safety of both our patients and our employees and to provide safe access to care for our community during the pandemic.”

The L&I action comes months after staff represented by the UAPD first made public their issues over a lack of N95 masks and other COVID safety issues they contend workers have faced while dealing with COVID-19 testing at the clinics.

In November, clinic workers participated in a two-day labor strike over the issue. One of the participants later tested positive with COVID-19. The union has noted that several of its workers have become ill during the pandemic.

Crane of UAPD told The News Tribune via email, “Multicare started fit testing (N95 masks) in response to our strike in November. But multiple providers that we represent, (medical assistants) and front desk staff who we don’t represent, failed that round of fit testing.”

Failed fit tests mean they didn’t fit, he explained.

“We are now nearing March, and those providers and other staff still do not have N95s that have been fitted and are safe for use,” he added.

This story was written by The News Tribune.