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A rule to address workplace violence in assisted living communities and some other long-term care and healthcare settings is under consideration by the Occupational Safety and Health Administration.

The agency is preparing a Small Business Regulatory Enforcement Fairness Act panel to develop a rule about Prevention of Workplace Violence in Health Care and Social Assistance, and that panel is scheduled to meet March 1. A final report would be released by May 1.

The Small Business Administration is seeking representatives from small businesses and small non-profit organizations from sectors subject to the rule to help review materials and analyses. In addition to residential care communities, the rule would apply to home healthcare agencies, hospitals, psychiatric hospitals, residential behavioral health facilities and other settings, according to OSHA. 

Following a December 2016 request for information from OSHA on the effects of violence in residential facilities, long-term care facilities and other settings, as well as prevention strategies, a broad coalition of labor unions and National Nurses United petitioned the agency for a standard for preventing workplace violence. 

OSHA granted the petitions in 2017, and the Biden administration included a workplace violence prevention in healthcare rule on its fall 2022 agenda of regulatory actions.

According to OSHA, workplace violence is more widespread in the healthcare and social assistance sectors — which includes residential care and community care — than in any other industry. In 2019, the rate of nonfatal workplace violence incidents that required a worker to take time off was almost five times greater in privately operated healthcare and social assistance establishments than in private industry overall, according to the agency. 

A 2019 study found that violence against long-term care staff members had become “normalized,” affecting worker morale and health, as well as quality of life for residents. The authors suggested that their findings could help inform prevention strategies for senior living communities around the world, including increased training and resources, funding, staffing levels, public awareness, and legal and regulatory measures.

Before that, a 2016 Government Accountability Office report recommended that OSHA better protect workers in residential care and other settings from workplace violence by assisting its inspectors in developing citations, following up on warnings and assessing results. 

A Workplace Violence Prevention for Health Care and Social Service Workers Act was introduced in the Senate last spring after a similar bill passed in the House of Representatives in 2021. The act — which was referred to the Senate Committee on Health, Education, Labor and Pensions — would have required senior living and other long-term care and healthcare providers to create workplace violence prevention plans to protect employees.