Healthcare Law Blog

What Kentucky Health Facilities Need to Know about Workplace Safety

Healthcare workplace violence is a recognized hazard in the healthcare industry. The U.S. Bureau of Labor Statistics reported in 2018 that approximately 73% of all nonfatal workplace violence injuries involved healthcare workers.[1] Even then, the incidence of workplace violence is likely higher due to underreporting.[2] Combined with the increased stress, isolation for patients and providers, and continued staffing issues and burnout, workplace violence has become one of the main contributors for healthcare workers to leave the field.[3]

National efforts have been proposed to address the issue. The Safety from Violence for Healthcare Employees Act (SAVE Act), for example, establishes a criminal offense for knowingly assaulting or intimidating hospital personnel while they are performing their official duties. It also authorizes grants to hospitals to reduce the incidence of violence at hospitals.

Kentucky is one of the leading states to enact new regulations for hospitals and all other health facilities to address workplace violence against healthcare workers within our state. KRS 216.703 now requires the Cabinet for Health and Family Service to establish guidelines for developing workplace safety assessments, plans, and standards specifically to prevent workplace violence against healthcare workers.

The Cabinet will begin annually auditing healthcare facilities for compliance starting January 1, 2025.

KRS 216.705 requires health facilities to develop and execute their own workplace safety assessments and plans tailored to the different types of healthcare workers operating on their premises. These plans and assessments must include security considerations and factors such as:

• Security systems, alarms, emergency response, and security personnel
• Staffing patterns, patient classifications, and procedures to mitigate violence
• Job design, equipment, and facilities
• First aid and emergency procedures
• Reporting of violent acts
• Healthcare worker education and training requirements
• Security risks with specific units
• Intervention procedures

KRS 216.707 sets requirements for violence prevention training that health facilities must provide to all healthcare workers, volunteers, and contracted security personnel. Training must occur within 90 days of the healthcare worker’s initial date of hire and at least annually. After the training, health facilities shall develop a competency test; hiring practices must also require that candidates can demonstrate competency using protective safety skills.

Training must include:

• Interactive questions and answers
• Hands-on training
• Video training
• Brochures
• Verbal training

Training must also address topics that were identified in the workplace safety assessment as hazards, such as:

• Workplace safety plan
• Behavioral predictors of violence
• Violence escalation cycle
• De-escalation techniques
• Strategies to prevent physical harm
• Response team processes
• Proper application of restrains
• Process to document and report incidents
• Debrief process for affected employees following violent acts
• Resources available to cope with the effects of violence

Lastly, there are now protections for healthcare workers within the criminal law sphere. KRS 508.025 took effect in 2024 and expanded the scope of Assault in the 3^rd Degree to include healthcare providers as defined in KRS 311.821 or other categories of persons employed within a healthcare facility setting if the event occurs in or on the premises of a healthcare facility. A person charged with Assault in the 3^rd Degree, Healthcare Provider faces a possible conviction of a Class D felony, which carries between 1 to 5 years in prison and a fine between $1,000 and $10,000.

Navigating new regulations regarding workplace violence prevention is daunting. With extensive experience in the practice of healthcare law, we have the knowledge and insight your organization needs to ensure that it is in compliance with the state regulations. If you face legal challenges or need advice, contact a healthcare attorney at McBrayer.

Valerie Michael is an Associate at McBrayer's Lexington office. Ms. Michael focuses her area of practice on healthcare law, handling a wide variety of matters, such as healthcare professional licensure defense, compliance, and regulatory issues. Ms. Michael can be reached at vmichael@mcbrayerfirm.com or (859) 231-8780.

Services may be performed by others. This article does not constitute legal advice.

[1] U.S. Bureau of Labor Statistics. Workplace Violence in healthcare, 2018. Accessed June 25, 2024. https://www.bls.gov/iif/factsheets/workplace-violence-healthcare-2018.htm

[2] Kenneth Rosenman, Alice Kalush, May Jo Reilly, Joseph C Gardiner, Mathew Reeves, & Zhewui Luo, How much work-related injury and illness is missed by the current national surveillance system? 48 J Occup Enviro Med 357 (2006).

[3] Mei Ching Lim, Mohammad Saffree Jeffree, Saihpudin Sahipudin Saupin, Nelbon Giloi, & Khamisah Awang Lukman, Workplace violence in healthcare settings: the risk factors, implications, and collaborative preventive measures, 78 Ann Med Surg 103727 (2022).