The Occupational Safety and Health Administration (OSHA) recently reminded us that every employer needs a violence in the workplace policy or risk citation for third party criminal actions. The OSH Act’s general duty clause requires employers to provide a workplace free from recognized hazards likely to cause death or serious physical harm to employees. OSHA clearly believes that third party criminal activity can be a recognized hazard and employers have an obligation to address it. It has gone so far as to issue Guidance for Preventing Workplace Violence for Healthcare and Social Services Workers to provide guidance to the healthcare industry on how to handle potentially dangerous patients or environments.

The Facts

Epic Health Services’ employees go into patient homes to provide home health services. According to OSHA, a number of Epic employees reported problems ranging from verbal assaults to domestic violence in the home to being physically groped. One nurse said the father in a home in which she provided services to a child attempted (sometimes successfully) to grope her and commented about her body and later physically assaulted her. (He was later charged with rape and sexual assault.) OSHA found that other employees had told Epic about the father’s prior assaults and the nurse said Epic did not warn her of the danger.

The Citation

OSHA cited Epic for exposing “employees to the risks of physical assaults as they provided nursing care services to both clients and family members and had no system for reporting threats or incidents of violence.” Additionally, OSHA cited Epic for “failing to report all instances of workplace violence, regardless of the severity.” OSHA characterized this as a willful violation– the employer “either knowingly failed to comply with a legal requirement (purposeful disregard) or acted with plain indifference to employee safety.” The fine is $98,000, which is, of course, not the end of the story–the nurse is suing the company for negligence.

Policy Options

What can employers do to both protect their employees and prevent such citations? OSHA suggests the following:

  • A written violence workplace prevention program
  • A hazard assessment and security procedures for each patient/client
  • Procedures to reduce the risk, including an option for employees to refuse to provide services in a hazardous situation (with no fear of retaliation)
  • Training
  • Procedures for when a violent incident occurs, including incident reports and investigation
  • A system for employees to report all workplace violence, regardless of severity

While some of these recommendations are unique to the healthcare industry, most are not. This applies to any employer whose employees interact with the public, are sent to other sites to perform work, or work with other people (who are not always stable).

Oh, and don’t forget that the cost of OSHA citations just increased significantly. The best practice is to let your employees know that you care about their safety, that they can report concerns and that you take them seriously, even if the threat involves a customer or patient. Not surprisingly, the best way to prove that you care is to have a written policy and enforce it.