(IV) to provide medical care or 
first aid to affected employees. 
(v) Procedures for emergency re-
sponse, including procedures for threats of 
mass casualties and procedures for inci-
dents involving a firearm or a dangerous 
weapon. 
(vi) Procedures for communicating 
with and training of covered employees on 
workplace violence hazards, threats, and 
work practice controls, the employer’s plan, 
and procedures for confronting, responding 
to, 
and 
reporting 
workplace 
violence 
threats, incidents, and concerns, and em-
ployee rights. 
(vii) Procedures for coordination of 
risk assessment efforts, Plan development, 
and implementation of the Plan with other 
employers who have employees who work 
at the covered facility or who are per-
forming the covered service. 
(viii) Procedures for conducting the 
annual evaluation under paragraph (6). 
(C) AVAILABILITY OF PLAN.—Each Plan 
shall be made available at all times to the cov-
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ered employees who are covered under such 
Plan. 
(2) VIOLENT INCIDENT INVESTIGATION.— 
(A) IN GENERAL.—As soon as practicable 
after a workplace violence incident, risk, or haz-
ard of which a covered employer has knowledge, 
the employer shall conduct an investigation of 
such incident, risk, or hazard under which the 
employer shall— 
(i) review the circumstances of the in-
cident, risk, or hazard, and whether any 
controls or measures implemented pursu-
ant to the Plan of the employer were effec-
tive; and 
(ii) solicit input from involved employ-
ees, their representatives, and supervisors, 
about the cause of the incident, risk, or 
hazard, and whether further corrective 
measures (including system-level factors) 
could have prevented the incident, risk, or 
hazard. 
(B) DOCUMENTATION.—A covered em-
ployer shall 
document 
the 
findings, 
rec-
ommendations, and corrective measures taken 
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for each investigation conducted under this 
paragraph. 
(3) TRAINING AND EDUCATION.—With respect 
to the covered employees covered under a Plan of a 
covered employer, the employer shall provide train-
ing and education to such employees who may be ex-
posed to workplace violence hazards and risks, which 
meet the following requirements: 
(A) Annual training and education includes 
information on the Plan, including identified 
workplace violence hazards, work practice con-
trol measures, reporting procedures, record 
keeping requirements, response procedures, and 
employee rights. 
(B) Additional hazard recognition training 
for supervisors and managers to ensure they 
can recognize high-risk situations and do not 
assign employees to situations that predictably 
compromise their safety. 
(C) Additional training for each such cov-
ered employee whose job circumstances has 
changed, within a reasonable timeframe after 
such change. 
(D) New employee training prior to assign-
ment. 
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(E) All training provides such employees 
opportunities to ask questions, give feedback on 
such training, and request additional instruc-
tion, clarification, or other follow up. 
(F) All training is provided in-person and 
by an individual with knowledge of workplace 
violence prevention and of the Plan. 
(G) All training is appropriate in content 
and vocabulary to the language, educational 
level, and literacy of such covered employees. 
(4) RECORDKEEPING
AND
ACCESS
TO
PLAN 
RECORDS.— 
(A) IN GENERAL.—Each covered employer 
shall— 
(i) maintain at all times— 
(I) records related to each Plan 
of the employer, including workplace 
violence risk and hazard assessments, 
and identification, evaluation, correc-
tion, and training procedures; 
(II) a violent incident log de-
scribed in subparagraph (B) for re-
cording all workplace violence inci-
dents; and 
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(III) records of all incident inves-
tigations as required under paragraph 
(2)(B); and 
(ii) make such records and logs avail-
able, upon request, to covered employees 
and their representatives for examination 
and copying in accordance with section 
1910.1020 of title 29, Code of Federal 
Regulations, and in a manner consistent 
with HIPAA privacy regulations (defined 
in section 1180(b)(3) of the Social Security 
Act (42 U.S.C. 1320d–9(b)(3))) and part 
2 of title 42, Code of Federal Regulations. 
(B) VIOLENT
INCIDENT
LOG
DESCRIP-
TION.—Each violent incident log shall— 
(i) be maintained by a covered em-
ployer for each covered facility controlled 
by the employer and for each covered serv-
ice being performed by a covered employee 
on behalf of such employer; 
(ii) be based on a template developed 
by the Secretary not later than 1 year 
after the date of enactment of this Act; 
(iii) include, at a minimum, a descrip-
tion of— 
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(I) the violent incident (including 
environmental risk factors present at 
the time of the incident); 
(II) the date, time, and location 
of the incident, names and job titles 
of involved employees; 
(III) identification of the alleged 
individual who committed the violence, 
in a manner consistent with HIPAA 
privacy regulations (defined in section 
1180(b)(3) of the Social Security Act 
(42 U.S.C. 1320d–9(b)(3))) and part 
2 of title 42, Code of Federal Regula-
tions; 
(IV) the nature and extent of in-
juries to covered employees; 
(V) the type of violent incident 
(such as type 1 violence, type 2 vio-
lence, type 3 violence, or type 4 vio-
lence); and 
(VI) 
how 
the 
incident 
was 
abated; 
(iv) not later than 7 days after the 
employer learns of such incident, contain a 
record of each violent incident, which is 
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(III) be posted for three months 
beginning February 1 of each year in 
a manner consistent with the require-
ments of section 1904 of title 29, 
Code of Federal Regulations, relating 
to the posting of summaries of injury 
and illness logs; 
(IV) be located in a conspicuous 
place or places where notices to em-
ployees are customarily posted; and 
(V) not be altered, defaced, or 
covered by other material. 
(ii) SECRETARY.—Not later than 1 
year after the promulgation of the interim 
final standard under section 101(a), the 
Secretary shall make available a platform 
for the electronic submission of annual 
summaries required under this paragraph. 
(5) ANNUAL
REPORT.—Not later than Feb-
ruary 15 of each year, each covered employer shall 
report to the Secretary, the frequency, quantity, and 
severity of workplace violence, and any incident re-
sponse and post-incident investigation (including 
abatement measures for the incidents) set forth in 
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the annual summary of the violent incident log de-
scribed in paragraph (4)(C). 
(6) ANNUAL EVALUATION.—Each covered em-
ployer shall conduct an annual written evaluation, 
conducted with the full, active participation of cov-
ered employees and employee representatives, of— 
(A) the implementation and effectiveness 
of the Plan, including a review of the violent in-
cident log; and 
(B) compliance with training required by 
each standard described in section 101, and 
specified in the Plan. 
(7) ANTI-RETALIATION.— 
(A) POLICY.—Each covered employer shall 
adopt a policy prohibiting any person (including 
an agent of the employer) from discriminating 
or retaliating against any employee for report-
ing, or seeking assistance or intervention from, 
a workplace violence incident, threat, or concern 
to the employer, law enforcement, local emer-
gency services, or a government agency, or par-
ticipating in an incident investigation. 
(B) PROHIBITION.—No covered employer 
shall discriminate or retaliate against any em-
ployee for reporting, or seeking assistance or 
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intervention from, a workplace violence incident, 
threat, or concern to the employer, law enforce-
ment, local emergency services, or a government 
agency, or for exercising any other rights under 
this paragraph. 
(C) ENFORCEMENT.—This paragraph shall 
be enforced in the same manner and to the 
same extent as any standard promulgated 
under section 6(b) of the Occupational Safety 
and Health Act (29 U.S.C. 655(b)). 
SEC. 104. RULES OF CONSTRUCTION. 
Notwithstanding section 18 of the Occupational Safe-
ty and Health Act of 1970 (29 U.S.C. 667)— 
(1) nothing in this title shall be construed to 
curtail or limit authority of the Secretary under any 
other provision of the law; and 
(2) the rights, privileges, or remedies of covered 
employees shall be in addition to the rights, privi-
leges, or remedies provided under any Federal or 
State law, or any collective bargaining agreement. 
SEC. 105. OTHER DEFINITIONS. 
In this title: 
(1) WORKPLACE VIOLENCE.— 
(A) IN GENERAL.—The term ‘‘workplace 
violence’’ means any act of violence or threat of 
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violence, without regard to intent, that occurs 
at a covered facility or while a covered employee 
performs a covered service. 
(B) EXCLUSIONS.—The term ‘‘workplace 
violence’’ does not include lawful acts of self-de-
fense or defense of others. 
(C) INCLUSIONS.—The term ‘‘workplace 
violence’’ includes— 
(i) the threat or use of physical force 
against a covered employee that results in 
or has a high likelihood of resulting in in-
jury, psychological trauma, or stress, with-
out regard to whether the covered em-
ployee sustains an injury, psychological 
trauma, or stress; and 
(ii) an incident involving the threat or 
use of a firearm or a dangerous weapon, 
including the use of common objects as 
weapons, without regard to whether the 
employee sustains an injury, psychological 
trauma, or stress. 
(2) TYPE 1 VIOLENCE.—The term ‘‘type 1 vio-
lence’’— 
(A) means workplace violence directed at a 
covered employee at a covered facility or while 
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performing a covered service by an individual 
who has no legitimate business at the covered 
facility or with respect to such covered service; 
and 
(B) includes violent acts by any individual 
who enters the covered facility or worksite 
where a covered service is being performed with 
the intent to commit a crime. 
(3) TYPE 2 VIOLENCE.—The term ‘‘type 2 vio-
lence’’ means workplace violence directed at a cov-
ered employee by customers, clients, patients, stu-
dents, inmates, or any individual for whom a covered 
facility provides services or for whom the employee 
performs covered services. 
(4) TYPE 3 VIOLENCE.—The term ‘‘type 3 vio-
lence’’ means workplace violence directed at a cov-
ered employee by a present or former employee, su-
pervisor, or manager. 
(5) TYPE 4 VIOLENCE.—The term ‘‘type 4 vio-
lence’’ means workplace violence directed at a cov-
ered employee by an individual who is not an em-
ployee, but has or is known to have had a personal 
relationship with such employee. 
(6) THREAT OF VIOLENCE.—The term ‘‘threat 
of violence’’ means a statement or conduct that 
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causes a person to fear for his or her safety because 
there is a reasonable possibility the person might be 
physically injured, and that serves no legitimate pur-
pose. 
(7) ALARM.—The term ‘‘alarm’’ means a me-
chanical, electrical, or electronic device that does not 
rely upon an employee’s vocalization in order to alert 
others. 
(8) DANGEROUS
WEAPON.—The term ‘‘dan-
gerous weapon’’ means an instrument capable of in-
flicting death or serious bodily injury, regardless of 
whether such instrument was designed for that pur-
pose. 
(9) ENGINEERING CONTROLS.— 
(A) IN GENERAL.—The term ‘‘engineering 
controls’’ means an aspect of the built space or 
a device that removes a hazard from the work-
place or creates a barrier between a covered 
employee and the hazard. 
(B) INCLUSIONS.—For purposes of reduc-
ing workplace violence hazards, the term ‘‘engi-
neering controls’’ includes electronic access con-
trols to employee occupied areas, weapon detec-
tors (installed or handheld), enclosed worksta-
tions with shatter-resistant glass, deep service 
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counters, separate rooms or areas for high-risk 
patients, locks on doors, removing access to or 
securing items that could be used as weapons, 
furniture affixed to the floor, opaque glass in 
patient rooms (which protects privacy, but al-
lows the health care provider to see where the 
patient is before entering the room), closed-cir-
cuit television monitoring and video recording, 
sight-aids, and personal alarm devices. 
(10) ENVIRONMENTAL RISK FACTORS.— 
(A) IN
GENERAL.—The term ‘‘environ-
mental risk factors’’ means factors in the cov-
ered facility or area in which a covered service 
is performed that may contribute to the likeli-
hood or severity of a workplace violence inci-
dent. 
(B) CLARIFICATION.—Environmental risk 
factors may be associated with the specific task 
being performed or the work area, such as 
working in an isolated area, poor illumination 
or blocked visibility, and lack of physical bar-
riers between employees and persons at risk of 
committing workplace violence. 
(11) PATIENT-SPECIFIC
RISK
FACTORS.—The 
term ‘‘patient-specific risk factors’’ means factors 
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specific to a patient that may increase the likelihood 
or severity of a workplace violence incident, includ-
ing a patient’s mental status, treatment and medica-
tion status, history of violence as known to a covered 
employee at a covered facility or while performing a 
covered service, use of drugs or alcohol as known to 
a covered employee at a covered facility or while per-
forming a covered service, and any other conditions 
or disease processes that may cause the patient to 
experience confusion or disorientation, to be non-re-
sponsive to instruction, or to behave unpredictably. 
(12) 
SECRETARY.—The 
term 
‘‘Secretary’’ 
means the Secretary of Labor. 
(13) WORK PRACTICE CONTROLS.— 
(A) IN GENERAL.—The term ‘‘work prac-
tice controls’’ means procedures and rules that 
are used to effectively reduce workplace violence 
hazards. 
(B) INCLUSIONS.—The term ‘‘work prac-
tice controls’’ includes assigning and placing 
sufficient numbers of staff to reduce patient- 
specific Type 2 workplace violence hazards, pro-
vision of dedicated and available safety per-
sonnel such as security guards, employee train-
ing on workplace violence prevention method 
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and techniques to de-escalate and minimize vio-
lent behavior, and employee training on proce-
dures for response in the event of a workplace 
violence incident and for post-incident response. 
TITLE II—AMENDMENTS TO THE 
SOCIAL SECURITY ACT 
SEC. 201. APPLICATION OF THE WORKPLACE VIOLENCE 
PREVENTION STANDARD TO CERTAIN FACILI-
TIES RECEIVING MEDICARE FUNDS. 
(a) IN GENERAL.—Section 1866 of the Social Secu-
rity Act (42 U.S.C. 1395cc) is amended— 
(1) in subsection (a)(1)— 
(A) in subparagraph (X), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (Y), by striking at 
the end the period and inserting ‘‘; and’’; and 
(C) by inserting after subparagraph (Y) 
the following new subparagraph: 
‘‘(Z) in the case of hospitals that are not other-
wise subject to the Occupational Safety and Health 
Act of 1970 (or a State occupational safety and 
health plan that is approved under 18(b) of such 
Act) and skilled nursing facilities that are not other-
wise subject to such Act (or such a State occupa-
tional safety and health plan), to comply with the 
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Workplace Violence Prevention Standard (as pro-
mulgated under section 101 of the Health Care 
Workplace Violence Prevention Act of 2018).’’; and 
(2) in subsection (b)(4)— 
(A) in subparagraph (A), by inserting 
‘‘and a hospital or skilled nursing facility that 
fails to comply with the requirement of sub-
section (a)(1)(Z) (relating to the Workplace Vi-
olence Prevention Standard)’’ after ‘‘Blood-
borne Pathogens Standard)’’; and 
(B) in subparagraph (B)— 
(i) by striking ‘‘(a)(1)(U)’’ and insert-
ing ‘‘(a)(1)(V)’’; and 
(ii) by inserting ‘‘(or, in the case of a 
failure to comply with the requirement of 
subsection (a)(1)(Z), for a violation of the 
Workplace Violence Prevention standard 
referred to in such subsection by a hospital 
or skilled nursing facility, as applicable, 
that is subject to the provisions of such 
Act)’’ before the period at the end. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply beginning on the date that is 
1 year after the date of issuance of the interim final stand-
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ard on workplace violence prevention required under sec-
tion 101. 
Æ 
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