Hospital’s Failure to Abate Patient and Visitor Violence Against Employees Results in OSHA Penalty

by BakerHostetler

Hospitals, remarkably, are one of the most hazardous places to work. According to the U.S. Bureau of Labor Statistics, hospital workers have an estimated rate of 8.3 assaults per 10,000 workers compared to an estimated 2 assaults per 10,000 workers in the overall work environment. With this background in mind, the Occupational Safety and Health Administration (OSHA) recently cited Brookdale University Hospital and Medical Center (Brookdale) for willfully failing to protect its employees from assaults by patients and visitors.

OSHA proposed a $70,000 fine for Brookdale’s failure to develop and implement adequate measures to protect its employees from the recognized likelihood of physical violence by patients and visitors. Violence can occur anywhere in a healthcare facility, according to the National Institute for Occupational Safety and Health (NIOSH), but tends to occur most frequently in psychiatric wards, emergency rooms, waiting rooms and geriatric units. Nurses and aides, who have the most direct contact with patients, are at higher risk of violence. The violence ranges in intensity and outcome, from minor to severe.

At Brookdale, OSHA found approximately 40 incidents of patient and visitor violence against Brookdale’s employees within a three-month period, including the full range of severity from minor abrasions to, in one instance, a nurse who sustained severe brain damage when she was attacked while attending to a patient.

While no federal standard specifically requires workplace violence prevention programs, OSHA requires hospitals to furnish a place of employment free from recognized hazards that are likely to cause death or serious physical harm to employees. 29 USC 654. Based upon this, OSHA found Brookdale’s workplace violence program to be ineffective to protect employees from serious harm. In fact, many employees were not even aware of the program’s existence. In its citation, OSHA suggested possible actions Brookdale could have taken, including developing and implementing an effective workplace violence prevention program, which typically includes management commitment, employee participation, worksite evaluation, hazard prevention and control, health and safety training, recordkeeping and program evaluation. These programs’ requirements are more specifically described by OSHA and NIOSH. OSHA also recommended that Brookdale employ engineering controls, such as installing panic alarm systems and protective barriers, distributing personal alarm systems for staff, as well as securing furniture and other items that could be used as weapons. Additionally, OSHA recommended training all employees on the workplace violence program and on recognizing potentially aggressive or violent behaviors. In addition, OSHA recommended that Brookdale develop post-incident procedures and provide services to treat traumatized employees.

Several states have implemented laws specifically requiring employers to establish comprehensive workplace violence prevention programs for healthcare employees. Some states have increased penalties for those convicted of assaults of a nurse or other healthcare personnel.

OSHA’s citation of Brookdale highlights the importance of developing and implementing an effective and comprehensive workplace violence prevention program in healthcare facilities, as well as periodically evaluating existing programs. Although risk factors for violence vary among healthcare facilities, the suggested remediation actions for Brookdale provide insight for other healthcare facilities to evaluate the effectiveness of their own workplace violence prevention programs.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© BakerHostetler | Attorney Advertising

Written by:


BakerHostetler on:

Readers' Choice 2017
Reporters on Deadline

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up using*

Already signed up? Log in here

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
Custom Email Digest
Privacy Policy (Updated: October 8, 2015):

JD Supra provides users with access to its legal industry publishing services (the "Service") through its website (the "Website") as well as through other sources. Our policies with regard to data collection and use of personal information of users of the Service, regardless of the manner in which users access the Service, and visitors to the Website are set forth in this statement ("Policy"). By using the Service, you signify your acceptance of this Policy.

Information Collection and Use by JD Supra

JD Supra collects users' names, companies, titles, e-mail address and industry. JD Supra also tracks the pages that users visit, logs IP addresses and aggregates non-personally identifiable user data and browser type. This data is gathered using cookies and other technologies.

The information and data collected is used to authenticate users and to send notifications relating to the Service, including email alerts to which users have subscribed; to manage the Service and Website, to improve the Service and to customize the user's experience. This information is also provided to the authors of the content to give them insight into their readership and help them to improve their content, so that it is most useful for our users.

JD Supra does not sell, rent or otherwise provide your details to third parties, other than to the authors of the content on JD Supra.

If you prefer not to enable cookies, you may change your browser settings to disable cookies; however, please note that rejecting cookies while visiting the Website may result in certain parts of the Website not operating correctly or as efficiently as if cookies were allowed.

Email Choice/Opt-out

Users who opt in to receive emails may choose to no longer receive e-mail updates and newsletters by selecting the "opt-out of future email" option in the email they receive from JD Supra or in their JD Supra account management screen.


JD Supra takes reasonable precautions to insure that user information is kept private. We restrict access to user information to those individuals who reasonably need access to perform their job functions, such as our third party email service, customer service personnel and technical staff. However, please note that no method of transmitting or storing data is completely secure and we cannot guarantee the security of user information. Unauthorized entry or use, hardware or software failure, and other factors may compromise the security of user information at any time.

If you have reason to believe that your interaction with us is no longer secure, you must immediately notify us of the problem by contacting us at In the unlikely event that we believe that the security of your user information in our possession or control may have been compromised, we may seek to notify you of that development and, if so, will endeavor to do so as promptly as practicable under the circumstances.

Sharing and Disclosure of Information JD Supra Collects

Except as otherwise described in this privacy statement, JD Supra will not disclose personal information to any third party unless we believe that disclosure is necessary to: (1) comply with applicable laws; (2) respond to governmental inquiries or requests; (3) comply with valid legal process; (4) protect the rights, privacy, safety or property of JD Supra, users of the Service, Website visitors or the public; (5) permit us to pursue available remedies or limit the damages that we may sustain; and (6) enforce our Terms & Conditions of Use.

In the event there is a change in the corporate structure of JD Supra such as, but not limited to, merger, consolidation, sale, liquidation or transfer of substantial assets, JD Supra may, in its sole discretion, transfer, sell or assign information collected on and through the Service to one or more affiliated or unaffiliated third parties.

Links to Other Websites

This Website and the Service may contain links to other websites. The operator of such other websites may collect information about you, including through cookies or other technologies. If you are using the Service through the Website and link to another site, you will leave the Website and this Policy will not apply to your use of and activity on those other sites. We encourage you to read the legal notices posted on those sites, including their privacy policies. We shall have no responsibility or liability for your visitation to, and the data collection and use practices of, such other sites. This Policy applies solely to the information collected in connection with your use of this Website and does not apply to any practices conducted offline or in connection with any other websites.

Changes in Our Privacy Policy

We reserve the right to change this Policy at any time. Please refer to the date at the top of this page to determine when this Policy was last revised. Any changes to our privacy policy will become effective upon posting of the revised policy on the Website. By continuing to use the Service or Website following such changes, you will be deemed to have agreed to such changes. If you do not agree with the terms of this Policy, as it may be amended from time to time, in whole or part, please do not continue using the Service or the Website.

Contacting JD Supra

If you have any questions about this privacy statement, the practices of this site, your dealings with this Web site, or if you would like to change any of the information you have provided to us, please contact us at:

- hide
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.