The CMS is warning hospitals of their duty to protect patients and employees from on-site violence amid growing concerns that the COVID-19 pandemic and resulting staffing shortages have spurred a rise in violent incidents.
Hospitals must effectively mitigate risks to ensure patients and staff are safe as part of their Medicare certification, the agency said in a Monday memo, noting that some facilities have received citations for failing to do so.
In one cited instance, a nurse in an understaffed unit was sexually assaulted by a behavioral health patient, according to the CMS.
In another, a patient was shot in their hospital room by off-duty police officers after the patient caused a scene and staff failed to appropriately deescalate.
“It is incumbent on the leadership at these healthcare facilities to ensure they provide adequate training, sufficient staffing levels, and ongoing assessment of patients and residents for aggressive behavior and indicators to adapt their care interventions and environment appropriately,” the agency said in the memo.
Healthcare workers are at a heightened risk of workplace violence and often interact with people who are aggressive, have behavioral issues or may be under the influence of drugs, the agency added.
Healthcare workers accounted for 73% of all non-fatal workplace injuries and illnesses due to violence in 2018, according to the Bureau of Labor Statistics.
Other reports suggest violent workplace incidents have risen throughout the COVID-19 pandemic.
A September survey from the American College of Emergency Physicians found that two-thirds of doctors working in emergency departments reported being assaulted in the past year alone. That survey also found 45% of physicians noted a spike in incidents in the past five years.
Healthcare workers in emergency units have been particularly vocal about increased violence on the job as strained departments lack the necessary staff and beds to tend to influxes of patients.
The ACEP and 30 other healthcare associations recently asked President Joe Biden to help find solutions to overcrowded hospital emergency rooms, lamenting in their letter that “boarding has become its own public health emergency.”
There is currently no federal legislation addressing workplace violence against healthcare workers, though the ACEP and others have pushed Congress to pass a bill that would require hospitals to develop comprehensive workplace violence prevention plans mandated through the Occupational Safety and Health Administration.