| A (slowly) changing landscape
OSHA has acknowledged workplace violence as "a serious and longstanding concern." The agency first issued "Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers" in 1996 and updated them in 2004 and 2016. In 2016, OSHA published a Request for Information on the extent and nature of workplace violence and the effectiveness of existing interventions. 81 FR 88147 (Federal Register, Dec. 7, 2016). In 2017, following petitions from labor unions, including National Nurses United, OSHA granted requests to develop a formal standard. A Small Business Advocacy Review panel convened in March 2023 issued its report in May 2023, advancing the rulemaking process. Now, the Department of Labor is auditing OSHA on workplace violence prevention for the first time in 25 years. According to the Spring 2025 regulatory agenda released in September 2025, OSHA moved its proposed rule on "Workplace Violence in Health Care and Social Assistance" to Long-Term Action status. This designation means regulatory action is not expected within twelve months — any federal standard remains at least a year away. The agency had previously planned to publish a proposed rule in June 2025, but now it appears employers will have time to appropriately prepare. Federal legislation also remains pending. The Workplace Violence Prevention for Health Care and Social Service Workers Act, introduced in the 119th Congress, would direct the Secretary of Labor to issue a standard requiring covered employers to develop and implement comprehensive workplace violence prevention plans based, at minimum, on OSHA's 2015 guidelines. The Joint Commission
Beyond governmental regulation, the Joint Commission implemented new and revised consensus-based standards in 2022, establishing a framework for effective hospital workplace violence prevention systems. These standards require hospitals to have a workplace violence prevention program led by a designated individual and developed by a multidisciplinary team, provide training and education at hire and regularly, establish policies for preventing and responding to violence, report incidents to analyze trends, support victims and witnesses, and complete worksite analyses with corrective actions. Looking ahead
Given the regulatory uncertainty at the federal level, healthcare leaders should take proactive steps now. OSHA and NIOSH recommend that all hospitals develop comprehensive violence prevention programs, recognizing that risk factors vary from facility to facility and unit to unit. Healthcare leaders cannot afford to wait for federal mandates. The legal risks under existing frameworks — including OSHA’s General Duty Clause and state-specific requirements — already create compliance obligations. — By MedCity InfluencersRobert Rodriguez, Stefan Borovina and Savannah McDonald |
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