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Hazardous Waste Management at Healthcare Facilities in Tennessee

Universal Waste and Hazardous Waste management requirements at healthcare facilities in Tennessee closely mirror the federal hazardous waste requirements promulgated by the U.S. Environmental Protection Agency (EPA). A recommended source of extensive guidance for dealing with waste management issues at healthcare facilities is the Healthcare Environmental Resource Center (HERC).

Further guidance can also be found in EPA’s August 26, 2010 draft EPA-821-R-10-006 on Best Management for Unused Pharmaceuticals at Health Care Facilities.

Note: Tennessee has a fee system on hazardous waste management that is potentially applicable to any hazardous waste generated at a healthcare facility. The hazardous waste fee requirements are found in Tennessee Rule 0400-12-01-.08

The Importance of a Viable Environmental Program

Violations of Tennessee’s hazardous or solid waste laws and regulations, or failing to pay applicable environmental fees, can potentially lead to civil fines and/or criminal prosecution. These fines can potentially be substantial. Further, knowing and willful violations (or a willful or substantially negligent disregard) of the state’s environmental laws can potentially lead to a felony conviction if the violations are serious.

The lack of a viable environmental compliance program can obviously be used as evidence of a lack of intent to comply. Deliberate violations are much more serious than occasional inadvertent violations or oversights while the facility is in substantial compliance and has made a good faith effort to comply. Willful and knowing violations can potentially lead to criminal prosecution. Conversely, organizations and companies that have made a good faith effort at compliance are typically able to demonstrate violations were not intentional and their violations are typically of a more minor nature. Therefore, it is important that each healthcare facility or organization make a good faith effort by having qualified environmental staff and/or contracts or support with a qualified environmental company(ies) to ensure compliance and to avoid the appearance of deliberate non-compliance or willful negligence. Many environmental and waste handling companies offer economical packages for compliance advice and support and/or may include such support as part of their waste handling package. 

Patient safety and welfare, the safety of healthcare professionals and technicians, and the safety of environmental staff handling wastes are primary concerns. Any environmental program must ensure patient and employee safety is not compromised. A good faith effort at an environmental waste management program, realizing occasional mishaps may occur, should help to eliminate or greatly reduce the chance of citations for substantial non-compliance and would be a significant mitigating factor if any violations were identified versus a facility that did not have a program. TDEC's inspectors have been briefed to fully respect the sensitive and critical nature, as well as privacy issues, associated with healthcare facilities. However, the lack of a program would alert the inspector to the strong possibility of substantial environmental compliance issues.

Medical Waste

Healthcare facilities may generate pharmaceutical waste, used oil, some types of maintenance waste, etc., that must be managed as hazardous waste prior to being sent for recycling or disposal.

Universal Waste

Healthcare facilities may have items like fluorescent lamps (bulbs), batteries, pesticides, and mercury-containing equipment, etc. that are potentiallty eligible to be managed as universal waste.