The Cost of Workplace Violence Under OSHA

Compliance Program Effectiveness: Auditing and Monitoring
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In healthcare facilities, workplace violence is an important issue that comes at a high price. Not only is workplace violence itself costly, but so are the fines OSHA issues in response. Recently OSHA has fined two healthcare facilities, one in Pennsylvania and one in Florida, for making employees and patients vulnerable to workplace violence.

OSHA fined a Pennsylvania hospital over $32,000 for exposing employees to workplace violence among other hazards. BHC Northwest Psychiatric Hospital, which was doing business as Brooke Glen Behavioral Hospital was cited on January 11, 2017 after OSHA received a complaint from employees at the hospital. The employees alleged that they were exposed to workplace violence and were not given clear access to restrooms. Upon investigation the hospital was cited under OSHA’s General Duty Clause for exposing employees to workplace violence. Incidents included employees being grabbed and hit with objects, punched, scratched, and bit by patients. The healthcare provider had two options. They could either correct the violations that prompted the fines or request an informal conference with the OSHA Area Director to discuss and or contest the violations.

In May 2018, an acute care impatient behavioral health facility in Bradenton, Florida, was cited for workplace violence. OSHA found that employees “were exposed to acts of workplace violence including but not limited to: physical assaults in the form of punches, kicks, bites, scratches, pulling, and the use of objects as weapons by patients throughout the facility.” The facility was cited for failing to take reasonable steps to protect the employees. The proposed penalties amounted to over $71,000. The health facility was also given the option to request an informal conference to contest their violations. If the violations were not successfully contested, they were to institute corrective action for all of the violations.

Workplace violence also has less obvious costs. Caregiver fatigue, injury, and stress are correlated with a higher risk of medication errors and patient infection. Further, stress and injuries are often factors that cause caregivers to leave the profession, requiring the employer to pay the cost of replacing their employees. For example, the estimated cost of replacing a nurse ranges from $27,000 to $103,000. Included in this cost is recruiting, hiring, orientation, and training. Thousands of dollars in additional costs could go to temporary staffing and overtime.

Prevention of workplace violence is much less costly than intervention. In order to avoid paying the costs of workplace violence, healthcare facilities should utilize the OSHA Workplace Violence Prevention Program. The core elements of the program are:

  1. management commitment and employee participation;
  2. worksite analysis and hazard identification;
  3. hazard prevention and control;
  4. safety and health training;
  5. record keeping and program evaluation.

Review OSHA’s Guidelines for preventing workplace violence for more information.


The First Healthcare Compliance cloud-based software solution creates confidence among compliance professionals through education, resources, and support in the areas of HIPAA, OSHA, human resources compliance, and fraud waste and abuse laws. Visit our website to learn more about our comprehensive compliance management solution for healthcare providers and explore our blogs for more information on OSHA. Register now for our upcoming webinar on May 21, 2019, “Recognizing & Defusing Aggressive Behavior Before Violence Erupts.”

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