Currently, OSHA has no standard covering workplace violence for healthcare workers despite the high risk of injury in that sector as a result of work-related violence. A recent Government Accountability Office (“GAO”) report, “Additional Efforts Needed to Help Protect Healthcare Workers from Workplace Violence” estimates that there are 15 million healthcare workers in the U.S. The report found that “[i]n 2013, there were over 153,000 workers reporting assault in healthcare facilities, and nearly 25,000 case of violence that were severe enough to cause the healthcare employee to have a reportable days-away-from-work injury, according to the Bureau of Labor Statistics (BLS).”

The extent of the problem of workplace violence in the healthcare industry is shown in the following chart:

Violent Injuries Resulting in Days Away from Work, by Industry, 2002–2013


OSHA has issued voluntary Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers which covers risk assessment, employee engagement, flagging high risk patients, environmental controls, recordkeeping, and evaluation. However, currently OSHA can only issue citations under the “general duty clause” of the OSH Act of 1970 which requires OSHA to show that (1) a condition or activity existed in the workplace which was hazardous to an employee, (2) this condition or activity is recognized as hazardous by either the employer or the industry, (3) the hazard is causing or may cause death or serious harm, and (4) there is a feasible means to eliminate or materially reduce the hazard. As an alternative, OSHA inspectors can issue non-binding hazard alert letters which, as the name suggests, are neither enforceable, nor trackable.

In its report (summarized in a Fact Sheet), the GAO had three recommendations:

  1. OSHA should improve its “training for inspectors on developing citations for workplace violence hazards.”
  2. OSHA should follow up on cases where a hazard alert letter was issued to determine what action the employer took to alleviate the situation or whether to make a follow-up inspection.
  3. OSHA should assess the current situation and decide whether anything more is needed, including developing a standard.

The Committee on Education and the Workforce Democrats’ recommended that “OSHA needs to use all of the tools at its disposal to protect healthcare workers from preventable injury due to workplace violence” including “adopting an enforceable workplace violence prevention standard.”

In several press releases, the United Steelworkers and the National Nurses United, as well as other labor unions, supported the GAO findings and called for a federal standard. Several unions have been successful in having state plans promulgate workplace violence in healthcare standards. Specifically, the SEIU Nurse Alliance of California petitioned California’s Occupational Safety and Health Standards Board to develop a Workplace Violence Prevention in Healthcare standard. In 2015, the Board proposed a standard and public comments were accepted through December 17, 2015. A final standard in California may be issued this summer.