[co-author: Leah Shepherd]

The Occupational Safety and Health Administration (OSHA) is preparing to release a proposed standard on workplace violence prevention in healthcare settings in December 2024

Quick Hits

• OSHA announced that it intends to release a proposed rule for a workplace violence prevention in healthcare and social service facilities in December 2024.
• The proposed rule will most likely apply to work performed in hospitals, medical centers, residential treatment centers, nursing homes, mental health centers, and private homes where home health aides or social workers visit clients.
• The agency is expected to publish a final rule in 2025.

Nearly 20 percent of healthcare professionals have experienced physical abuse at the workplace, according to research published by StatPearlsin January 2024.

According to OSHA, nonfatal workplace violence is more widespread in the healthcare and social assistance sectors than in any other industry. For this reason, OSHA has long identified a workplace violence prevention standard for healthcare as a priority.

Background

In March 2023, OSHA convened a Small Business Advocacy Review panel to collect input from small businesses on a proposed rule. After receiving comments from a broad range of healthcare and social assistance providers, the panel recommended that the proposed rule be flexible and allow employers to tailor their approaches to the size and complexity of their facilities, settings, or industries. It said the rule should include flexibility in applying standards for engineering and administrative controls, such as alarm systems, cameras, bright lighting, and security officers. It also recommended that OSHA reconsider the definition of a workplace violence incident, particularly whether verbal threats should be considered workplace violence incidents.

The future proposed rule is likely to include elements such as requiring healthcare employers to:

• develop a written workplace violence prevention policy;
• train workers on that policy;
• perform regular hazard assessments;
• take steps to mitigate hazards; and
• maintain a workplace violence incident log.

In its Fall 2022 Statement of Regulatory Priorities, the U.S. Department of Labor (DOL) indicated that OSHA would move toward rulemaking on a workplace violence prevention standard for the healthcare industry. However, the DOL did not mention this rulemaking goal in its Fall 2023 Statement of Regulatory Priorities.

In January 2017, OSHA published an updated compliance directive, giving compliance officers guidance for responding to complaints of workplace violence against healthcare providers. It recognized workplace violence in healthcare settings as a known risk.

In 2016, OSHA published Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, highlighting OSHA’s focus on the “serious hazards” of “job-related violence” against healthcare workers.

Next Steps

If the proposed rule is published in December 2024, a comment period of thirty to sixty days will follow its publication. The agency is then expected to publish a final rule in 2025. Barring potential court challenges, the new standard would likely take effect in thirty to sixty days after a final rule is published in the Federal Register.

Currently, in the absence of a workplace violence prevention standard for healthcare facilities, OSHA has taken the position that it can hold companies accountable under the General Duty Clause of the Occupational Safety and Health (OSH) Act, which requires all private employers to provide a workplace free from hazards that may cause death or serious physical harm.

In anticipation of what could be a final rule in 2025, healthcare employers and social service providers may want to review any existing workplace safety policies with regard to the potential threat of workplace violence by patients and clients and revise as needed in anticipation of the coming standard.