Source: https://privatedutyforum.decisionhealth.com/discussion/1001/part-3-violence-against-homecare-field-staff-what-to-do
Timestamp: 2020-05-30 20:11:17
Document Index: 653085218

Matched Legal Cases: ['art 3', 'art 3', 'art 1', 'art 2', 'art 3', 'art 1', 'art 2', 'art_000', 'art 3', 'art 3', 'art 3', 'art 3', 'art 3', 'art 1', 'art 2', 'art_000']

Part 3 - Violence Against Homecare Field Staff: What to Do — Private Duty Home Care Forum
Part 3 - Violence Against Homecare Field Staff: What to Do
September 2016 edited May 2017 in General Discussions
The following article provides guidance about how to terminate services to
patients in the face of violence or threatened violence against field staff
members. Feel free to share this information. If you decide to use this
material, please include our copyright designation that is shown at the end
of the article and send us a copy of any publication in which the material
Please do not hesitate to contact us with comments, questions, or requests
Homecare field staff members who provide services on behalf of private duty
agencies, hospices, Medicare-certified home health agencies and home medical
equipment (HME) companies are extremely vulnerable. Contributing to their
vulnerability is the fact that they work alone on territory that may be
unfamiliar and over which they have little control. Staff members certainly
need as much protection as possible.
In Part 1 of this series, exposure to workplace violence was reviewed from
the point of view of requirements of the Occupational Safety and Health
Administration (OSHA). Part 2 of this series addressed the potential
liability of home care providers of all types for negligence when employees
are injured as a result of violence.
The purpose of this article is provide guidance about how to terminate
services to patients in the face of violence or threatened violence.
Providers are at risk for legal liability when they terminate services to
patients. Violence or threatened violence, however, likely warrants
immediate termination of services. Providers are understandably concerned
about the possibility of legal liability associated with the termination of
beneficial services.
Specifically, providers remain concerned about the possibility of liability
for abandonment of patients. Practitioners often speak of abandonment as
though it is equivalent to termination of services. On the contrary,
patients who want to hold case managers liable for abandonment must show
1.	Providers unilaterally terminated the provider/patient relationship
2.	Without reasonable notice
3.	When further action was needed
Patients who fail to prove any one of these requirements are likely to lose
their lawsuits against providers.
As indicated above, abandonment requires unilateral termination of the
relationship between the patient and the provider by the provider. In
instances of violence or threatened violence, this requirement of proof of
abandonment may be met when providers decide unilaterally to discontinue
The second requirement of abandonment means that providers who give patients
reasonable notice prior to termination of services will not be liable for
abandonment. The key question is: what is "reasonable" notice? Providers
should view what is reasonable on a continuum. That is, on one extreme end
of the spectrum are patients who are violent or threaten violence.
Practitioners are likely justified in terminating services immediately to
patients who fall into this category. Providers are also likely justified
in ending services to patients whose family members threaten violence or are
actually violent.
Statutes and/or regulations in some states govern how much notice must be
given to patients prior to termination of services. Some of these statutes
address the issues of violence or threatened violence and permit providers
to terminate services to patients immediately under these circumstances.
Providers must carefully review requirements for the state in which the
patient resides before terminating services.
After staff members agree that immediate termination of services due to
violence or threatened violence is reasonable, patients and attending
physicians should receive notice verbally and in writing. Written notices
should be hand-delivered to patients' homes. Although it is desirable, it
is unnecessary to obtain a signature verifying receipt. Written notices to
physicians may be faxed or hand-delivered.
After giving notice, providers must terminate care as planned.
Practitioners are sometimes tempted to continue services in the face of
pleas from patients, physicians, and/or family members. Providers must bear
in mind, however, that one of their most important responsibilities is to
protect staff members from harm.
Finally, providers can defeat claims of abandonment if patients for whom
services are discontinued need no further attention. How do providers know
whether further attention is needed? Is this requirement as subjective as
it appears? On the contrary, judges are likely to make retrospective
determinations about whether further attention was needed. The basis for
such determinations will probably be whether patients were injured as a
result of termination. In other words, the law is likely to conclude that
no further attention was needed, so long as patients are not injured as a
result of termination of services.
What kind of injury must patients prove? Can patients who attempt to prove
emotional damage only as a result of termination of services win lawsuits?
The "good news" for providers is that courts generally require proof of
physical injury or damage before they will find providers liable for
abandonment. Providers must, therefore, take appropriate steps to make
certain that patients are not physically injured as a result of termination
In rare instances, appropriate action may include sending an ambulance to
take a patient to the nearest hospital. Even if patients refuse transport
by ambulance, providers may avoid liability because patients likely assumed
the risk or were contributorily negligent when they refused transport via
It does not appear that the world is becoming a kinder, gentler place for
anyone. Field staff members must face their vulnerability every day. Those
who are behind the firing line must provide support by shielding them from
threatened or actual violence whenever possible.
CCopyright, 2016. Elizabeth E. Hogue, Esq. All rights reserved.
No portion of this material may be reproduced in any form without the
advance written permission of the author.
krasmussen@prmc.org
Dear Elizabeth Hogue,
May I please share this email with my field staff? I have 4 RN's, 3 PT's, 1 OT, 1 ST and a couple of PTA's and OTA's I'd like to share this with. We actually had to terminate a patient because he was training his dog to attack us. Needless to say, we chose to terminate and gave him resources to find other services.
Kelly Rasmussen, RN, HCS-D, Administrator
Home Health Agency & Pratt Home Care
620-450-1647 (phone)
620-450-1649 (fax)
From: Elizabeth Hogue [mailto:elizabethhogue@elizabethhogue.net]
Sent: Wednesday, September 07, 2016 1:08 PM
To: Multiple recipients of list Private Duty Insider-L
Subject: [privatedutyinsider-l] Part 3 - Violence Against Homecare Field Staff: What to Do
The following article provides guidance about how to terminate services to patients in the face of violence or threatened violence against field staff members. Feel free to share this information. If you decide to use this material, please include our copyright designation that is shown at the end of the article and send us a copy of any publication in which the material appears.
Homecare field staff members who provide services on behalf of private duty agencies, hospices, Medicare-certified home health agencies and home medical equipment (HME) companies are extremely vulnerable. Contributing to their vulnerability is the fact that they work alone on territory that may be unfamiliar and over which they have little control. Staff members certainly need as much protection as possible.
In Part 1 of this series, exposure to workplace violence was reviewed from the point of view of requirements of the Occupational Safety and Health Administration (OSHA). Part 2 of this series addressed the potential liability of home care providers of all types for negligence when employees are injured as a result of violence.
The purpose of this article is provide guidance about how to terminate services to patients in the face of violence or threatened violence. Providers are at risk for legal liability when they terminate services to patients. Violence or threatened violence, however, likely warrants immediate termination of services. Providers are understandably concerned about the possibility of legal liability associated with the termination of beneficial services.
1. Providers unilaterally terminated the provider/patient relationship
2. Without reasonable notice
3. When further action was needed
The second requirement of abandonment means that providers who give patients reasonable notice prior to termination of services will not be liable for abandonment. The key question is: what is "reasonable" notice? Providers should view what is reasonable on a continuum. That is, on one extreme end of the spectrum are patients who are violent or threaten violence. Practitioners are likely justified in terminating services immediately to patients who fall into this category. Providers are also likely justified in ending services to patients whose family members threaten violence or are actually violent.
After staff members agree that immediate termination of services due to violence or threatened violence is reasonable, patients and attending physicians should receive notice verbally and in writing. Written notices should be hand-delivered to patients' homes. Although it is desirable, it is unnecessary to obtain a signature verifying receipt. Written notices to physicians may be faxed or hand-delivered.
What kind of injury must patients prove? Can patients who attempt to prove emotional damage only as a result of termination of services win lawsuits? The "good news" for providers is that courts generally require proof of physical injury or damage before they will find providers liable for abandonment. Providers must, therefore, take appropriate steps to make certain that patients are not physically injured as a result of termination of services.
(c)Copyright, 2016. Elizabeth E. Hogue, Esq. All rights reserved.
To access the web interface, go to http://www.decisionhealth.com/privateduty-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages. To read messages on the web interface only, set Membership Type to ?no mail.? To see the archive of past messages, click on the Messages tab and the Show More button. To view the chat forum, click on the Conference tab. To unsubscribe, click on the My Forums tab.
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You are welcome to do so. Thanks for asking in advance.
From: Kelly Rasmussen [mailto:krasmussen@prmc.org]
Sent: Wednesday, September 07, 2016 4:08 PM
Subject: RE: [privatedutyinsider-l] Part 3 - Violence Against Homecare Field
Staff: What to Do
May I please share this email with my field staff? I have 4 RN's, 3 PT's, 1
OT, 1 ST and a couple of PTA's and OTA's I'd like to share this with. We
actually had to terminate a patient because he was training his dog to
attack us. Needless to say, we chose to terminate and gave him resources to
find other services. J
CONFIDENTIALITY NOTICE: This email message and any attachments are for the
Subject: [privatedutyinsider-l] Part 3 - Violence Against Homecare Field
http://www.decisionhealth.com/privateduty-l and enter your e-mail address.
Click on the My Account tab and then the Advanced tab to set or change your
password. Click on the Essentials tab and Membership Type to set the way you
want to access list messages. To read messages on the web interface only,
set Membership Type to ?no mail.? To see the archive of past messages,
click on the Messages tab and the Show More button. To view the chat forum,
click on the Conference tab. To unsubscribe, click on the My Forums tab.
set Membership Type to "no mail." To see the archive of past messages,
You are welcome to do =
so. Thanks for asking in advance.
Elizabeth E. Hogue, =
Office: =
Fax: (877) =
871-9739
@HogueHomecare
Kelly Rasmussen [mailto:krasmussen@prmc.org]
September 07, 2016 4:08 PM
To: Multiple recipients of list =
Private Duty Insider-L
Subject: RE: [privatedutyinsider-l] =
Part 3 - Violence Against Homecare Field Staff: What to =
Dear Elizabeth =
May I please share this email =
with my field staff? I have 4 RN’s, 3 PT’s, 1 OT, 1 ST and a =
couple of PTA’s and OTA’s I’d like to share this with. =
We actually had to terminate a patient because he was training his dog =
to attack us. Needless to say, we chose to terminate and gave him =
resources to find other services. J =
Kelly Rasmussen, RN, HCS-D, =
Pratt Regional Medical =
Home Health Agency & Pratt Home =
Pratt, KS =
620-450-1647 =
620-450-1649 =
CONFIDENTIALITY NOTICE: =
This email message and any attachments are for the sole use of the =
intended recipient(s) and may contain proprietary, confidential, trade =
secret or privileged information. Any unauthorized review, use, =
disclosure or distribution is prohibited and may be a violation of =
law. If you are not the intended recipient or a person responsible =
for delivering this message to an intended recipient, please contact the =
sender by reply email and destroy all copies of the original =
Elizabeth Hogue [mailto:elizabethhogue@e=
lizabethhogue.net]
Sent: Wednesday, September 07, 2016 =
To: Multiple recipients of list Private Duty =
Subject: [privatedutyinsider-l] Part 3 - Violence =
Against Homecare Field Staff: What to =
The following article provides guidance about how to =
terminate services to patients in the face of violence or threatened =
violence against field staff members. Feel free to share this =
information. If you decide to use this material, please include =
our copyright designation that is shown at the end of the article and =
send us a copy of any publication in which the material =
Please do =
not hesitate to contact us with comments, questions, or requests =
Part 3 - =
Violence against Homecare Field Staff: What to =
Homecare =
field staff members who provide services on behalf of private duty =
agencies, hospices, Medicare-certified home health agencies and home =
medical equipment (HME) companies are extremely vulnerable. =
Contributing to their vulnerability is the fact that they work alone on =
territory that may be unfamiliar and over which they have little =
control. Staff members certainly need as much protection as =
In Part 1 of =
this series, exposure to workplace violence was reviewed from the point =
of view of requirements of the Occupational Safety and Health =
Administration (OSHA). Part 2 of this series addressed the =
potential liability of home care providers of all types for negligence =
when employees are injured as a result of violence. =
The purpose of this article is provide guidance about =
how to terminate services to patients in the face of violence or =
threatened violence. Providers are at risk for legal liability =
when they terminate services to patients. Violence or threatened =
violence, however, likely warrants immediate termination of =
services. Providers are understandably concerned about the =
possibility of legal liability associated with the termination of =
Specifically, providers remain concerned about the =
possibility of liability for abandonment of patients. =
Practitioners often speak of abandonment as though it is equivalent to =
termination of services. On the contrary, patients who want to =
hold case managers liable for abandonment must show =
Providers unilaterally terminated the =
Without reasonable =
Patients who =
fail to prove any one of these requirements are likely to lose their =
lawsuits against providers.
As indicated =
above, abandonment requires unilateral termination of the relationship =
between the patient and the provider by the provider. In instances =
of violence or threatened violence, this requirement of proof of =
abandonment may be met when providers decide unilaterally to discontinue =
The second requirement of abandonment means that =
providers who give patients reasonable notice prior to termination of =
services will not be liable for abandonment. The key question is: =
what is "reasonable" notice? Providers should view what =
is reasonable on a continuum. That is, on one extreme end of the =
spectrum are patients who are violent or threaten violence. =
Practitioners are likely justified in terminating services immediately =
to patients who fall into this category. Providers are also likely =
justified in ending services to patients whose family members threaten =
violence or are actually violent.
Statutes =
and/or regulations in some states govern how much notice must be given =
to patients prior to termination of services. Some of these =
statutes address the issues of violence or threatened violence and =
permit providers to terminate services to patients immediately under =
these circumstances. Providers must carefully review requirements =
for the state in which the patient resides before terminating =
After staff members agree that immediate termination =
of services due to violence or threatened violence is reasonable, =
patients and attending physicians should receive notice verbally and in =
writing. Written notices should be hand-delivered to =
patients’ homes. Although it is desirable, it is unnecessary =
to obtain a signature verifying receipt. Written notices to =
After giving =
notice, providers must terminate care as planned. Practitioners =
are sometimes tempted to continue services in the face of pleas from =
patients, physicians, and/or family members. Providers must bear =
in mind, however, that one of their most important responsibilities is =
to protect staff members from harm.
Finally, =
providers can defeat claims of abandonment if patients for whom services =
are discontinued need no further attention. How do providers know =
whether further attention is needed? Is this requirement as =
subjective as it appears? On the contrary, judges are likely to =
make retrospective determinations about whether further attention was =
needed. The basis for such determinations will probably be whether =
patients were injured as a result of termination. In other words, =
the law is likely to conclude that no further attention was needed, so =
long as patients are not injured as a result of termination of =
What kind of injury must patients prove? Can =
patients who attempt to prove emotional damage only as a result of =
termination of services win lawsuits? The "good news" =
for providers is that courts generally require proof of physical injury =
or damage before they will find providers liable for abandonment. =
Providers must, therefore, take appropriate steps to make certain that =
patients are not physically injured as a result of termination of =
In rare =
instances, appropriate action may include sending an ambulance to take a =
patient to the nearest hospital. Even if patients refuse transport =
by ambulance, providers may avoid liability because patients likely =
assumed the risk or were contributorily negligent when they refused =
transport via ambulance.
It does not =
appear that the world is becoming a kinder, gentler place for =
anyone. Field staff members must face their vulnerability every =
day. Those who are behind the firing line must provide support by =
shielding them from threatened or actual violence whenever =
©Copyright, 2016. Elizabeth E. =
Hogue, Esq. All rights reserved.
No portion of this =
material may be reproduced in any form without the advance written =
permission of the =
---To access the =
web interface, go to http://www.decisionh=
ealth.com/privateduty-l and enter your e-mail address. Click on the =
My Account tab and then the Advanced tab to set or change your password. =
Click on the Essentials tab and Membership Type to set the way you want =
to access list messages. To read messages on the web interface only, set =
Membership Type to ?no mail.? To see the archive of past messages, =
click on the Messages tab and the Show More button. To view the chat =
forum, click on the Conference tab. To unsubscribe, click on the My =
Forums tab.---To access the =
Membership Type to “no mail.” To see the archive of =
past messages, click on the Messages tab and the Show More button. To =
view the chat forum, click on the Conference tab. To unsubscribe, click =
on the My Forums tab.
------=_NextPart_000_01D3_01D20923.573397B0--
807 General Discussions