Workplace Violence Puts Healthcare Employers at Legal Risk

Quick Hits

• The rate of workplace violence against healthcare workers has increased sharply in recent years.
• Under federal law and some state laws, employers are obligated to maintain a workplace that is free from foreseeable hazards, including workplace violence.
• Certain administrative and environmental solutions may lower the risk of violence in healthcare settings.

Doctors, nurses, psychiatric aides, and home health aides may suffer assaults or other violence from patients, patients’ family members, or visitors. Incidents of workplace violence increased by 30 percent across all healthcare facility types from 2011 to 2022, according to research from the National Institutes of Health (NIH). Rates of workplace violence tend to be higher in emergency departments, psychiatric facilities, substance abuse facilities, and home healthcare settings, compared to other healthcare workplaces, the study found.

Certain factors can heighten the risk of workplace violence, including exchanging money with the public, working with volatile people, working late at night, and working in locations with high crime rates, according to the U.S. Occupational Safety and Health Administration (OSHA). Those factors are present at many healthcare facilities.

Along with immediate physical harm, workplace violence also leads to psychological distress, decreased job satisfaction, and higher turnover rates for healthcare workers, the NIH research found.

OSHA Rule and State Laws

The general duty clause of the Occupational Health and Safety (OSH) Act of 1970 requires employers provide a workplace “free from recognized hazards that are causing or are likely to cause death or serious physical harm.”

OSHA convened a Small Business Advocacy Review panel in March 2023 to consider a potential standard for prevention of workplace violence in healthcare and social assistance settings. The panel issued a report on May 1, 2023. However, in 2025, OSHA listed the date for a notice of proposed rulemaking as “to be determined,” meaning it is a long-term action item and not likely to be finalized in 2026.

In 2015, OSHA released updated guidelines for preventing workplace violence in healthcare settings.

Notably, New York State recently enacted a new law that will require hospitals and nursing homes in the state to establish workplace violence prevention programs and require hospitals to conduct annual workplace safety and security assessments, beginning in 2027. California, Connecticut, Illinois, Maine, Maryland, Minnesota, New Jersey, Oregon, Texas, and Washington have similar state laws.

Preventive Measures

To reduce workplace violence, employers in the healthcare industry can rely on strategies like reporting workplace violence incidents, collecting data to identify trends over time, conducting risk assessments, implementing post-incident response protocols, training staff on violence prevention, and maintaining a culture of workplace safety. Effective communication among healthcare staff may help them take additional safety measures when dealing with a patient with a known history of violence or aggression.

The OSH Act prohibits employers from retaliating against workers for reporting injuries or submitting safety complaints to OSHA.

Security measures like having security guards, cameras, adequate lighting, panic buttons, clear exit routes, bulletproof glass, and metal detectors to identify weapons may help healthcare facilities to prevent or mitigate workplace violence. Securing furniture and other items so they cannot be used as weapons may be helpful in some facilities. Making wait times shorter and waiting rooms more comfortable may alleviate the stress of patients and their family members, according to the OSHA guidelines. Typically, healthcare facilities must balance any security measures with the need to be open and accessible to patients and their family members.

Ogletree Deakins’ Healthcare Industry Group, Workplace Safety and Health Practice Group, and Workplace Violence Prevention Practice Group will continue to monitor developments and will provide updates on the Healthcare, Workplace Safety and Health, and Workplace Violence Prevention blogs as new information becomes available.

In addition, the Ogletree Deakins Client Portal also covers developments in Workplace Violence Prevention, including healthcare-specific requirements. For more information on the Client Portal or a Client Portal subscription, please reach out to clientportal@ogletree.com.

Cynthia A. Bremer is a shareholder in Ogletree Deakins’ Minneapolis office.

Karen F. Tynan is a shareholder in Ogletree Deakins’ Sacramento office.

This article was co-authored by Leah J. Shepherd, who is a writer in Ogletree Deakins’ Washington, D.C., office.

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