According to the Bureau of Labor Statistics, healthcare and social service workers are nearly five times more likely to experience a serious workplace violence injury than employees in other industries.

Senior living and care communities are at the heart of this striking statistic. Nursing aides in long-term care facilities have the highest rate of workplace attacks. The majority of these assaults occur while performing tasks involving close interactions with residents, such as repositioning them, feeding and bathing them and helping them dress. The attackers typically are those with diagnoses of dementia, Alzheimer’s disease or other mental health disorders.

Given these alarming numbers, senior living communities clearly are on notice of the potential danger to their employees and, thus, could be found liable for such foreseeable and preventable attacks. In fact, in a matter of first impression, the Occupational Safety and Health Review Commission on March 4, ruled that the Occupational Safety and Health (OSH) Act’s general duty clause requires employers to protect employees from workplace violence. In Secretary of Labor v. Integra Health Management, Inc., the commission affirmed a citation issued to Integra after one of its employees was fatally stabbed by a mentally ill client during a required home visit. Unknown to the employee and Integra, the client had a prior criminal record, including convictions for aggravated assault and battery.

After several home visits with the member, the employee submitted reports to her supervisors in which she identified disturbing behavior from the client and said she was uncomfortable being alone with him. Notwithstanding, the employee returned to his home to complete her required assessment. During her visit, the patient attacked the employee and fatally stabbed her nine times.

Thereafter, Occupational Safety and Health Administration issued Integra a citation alleging a violation of the general duty clause for exposing employees “to the hazard of being physically assaulted by [residents] with a history of violent behavior.” The general duty clause states “each employer … shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.” The commission upheld the administrative law judge’s decision that workplace violence could be cited under the general duty clause.

House Democrats also are advocating for more protection for healthcare and social service workers with a new bill referred to as the Workplace Violence Prevention for Health Care and Social Service Workers Act, introduced by Rep. Joe Courtney (D-CT). The bill was heard before the House Subcommittee on Workforce Protections, which has a jurisdiction including OSHA, on Feb. 27, 2019, and could reach the House floor soon. The bill would require OSHA to issue a standard that requires healthcare and social service industry employers to develop and implement a comprehensive workplace violence prevention plan.

Integra makes clear that senior living community employers have a responsibility to manage the risk of workplace violence under the general duty clause. Employers can start by reviewing their safety policies and procedures and employee training programs to confirm they effectively reduce employees’ exposure to resident assaults.

To have an effective safety program, multiple components are crucial:

  • First, residents should be adequately screened for violent tendencies or a history of violent behavior.
  • Next, this information must be communicated to all employees.
  • Security devices — including surveillance cameras, alarm systems or panic buttons, employee communication devices such as phones or beepers, and keycard access systems — should be used throughout the facility.
  • Residents’ rooms also should be designed with safety in mind, including furnishings that are lightweight with no sharp edges, a secondary exit for employees to escape and removal of objects that could be used as weapons.
  • Finally, and most importantly, all employees, including managers, must be trained on proper safety protocols. This includes how to prevent and respond to violent situations or attacks, including self-defense measures, and requiring employees to report all instances of violence, even if no injuries occur.

The best defense against resident attacks is a good offense. Do not delay in implementing a thorough and effective workplace safety program for your facility. Your business and employees’ well-being depends on it.