Texas HSC Chapter 331
Chapter 331: The Physician & Security Committee Seats
When Texas HSC Chapter 331 requires a physician and a security-services employee on your WVP committee — how the conditional seats work and how to document them.
Texas HSC Chapter 331 requires a physician who provides direct patient care on your workplace violence prevention committee only if the facility employs any physicians, and a security-services employee only if the facility employs any. Both are conditional seats that turn on employment. The mandatory seat — a registered nurse providing direct care — is required of every covered facility.
These two conditional seats are where committee composition most often goes sideways at survey, because facilities misjudge the employment test or fail to document why a seat is empty. This article works through exactly when each seat is required, why "employment" is the deciding word, and the paper trail that keeps the decision defensible. For the full committee picture, see who must serve on a Chapter 331 WVP committee and our pillar, Texas SB 240 & HSC Chapter 331 compliance.
#The mandatory seat versus the conditional seats
Chapter 331 names three member categories, and the difference between them is the whole game.
| Member category | Required? | The deciding condition |
|---|---|---|
| Registered nurse providing direct patient care | Mandatory | Every covered facility must seat one. |
| Physician providing direct patient care | Conditional | Required only if the facility employs any physicians. |
| Security-services employee | Conditional | Required only if the facility employs any security-services personnel. |
(Source: Texas HSC Chapter 331; SB 240, 88th Leg., 2023.)
The RN-direct-care seat is non-negotiable and covered in depth in our committee members article. This piece is about the two seats that depend on a fact about your workforce.
#The physician seat: conditional on employment
A physician who provides direct patient care must serve if the facility employs any physicians. The operative word is employs.
Many hospitals and facilities operate almost entirely with independent or contracted physicians — privileged but not employed. If a facility employs no physicians, the physician seat is not required. But a surveyor will not assume that; the facility has to be able to show it.
The distinction:
- Employed physician — a W-2 employment relationship with the facility. If any exist, seat one who provides direct care.
- Independent / contracted physician — privileged or under a professional-services arrangement, not employed. If these are all you have, the seat is not triggered.
If you do not seat a physician, document why: a short note in the committee charter or a personnel attestation that the facility employs no physicians. That single sentence is what turns an "empty seat" from a deficiency into a documented, compliant decision.
#The security-services seat: conditional on employment
The same logic governs the security-services employee. The seat is required only if the facility employs any security-services personnel.
This is the one place "security" appears in Chapter 331's committee rule — and it is strictly a committee-membership matter. It does not turn your workplace violence prevention program into a guarding or patrol operation. A compliant program is a documentation and preparedness program; the seat exists to bring an environment-of-care security perspective to the table, not to staff guards.
The employment test mirrors the physician seat:
- Employed security staff — if the facility directly employs security personnel, seat one on the committee.
- Contracted security — many facilities contract the security function to a third-party vendor and employ no security staff themselves. If so, the seat may not be required.
Whichever applies, document the arrangement. A note that the facility contracts its security function and employs no security-services personnel is the record that supports leaving the seat unfilled.
Scope reminder: nothing about this seat obligates a facility to add security staffing. Chapter 331 is satisfied by the committee structure and the documentation behind it, not by headcount on a patrol roster.
#Why surveyors probe the conditional seats hardest
A surveyor's job is to confirm the committee meets the statutory composition — and the conditional seats are where facilities are most likely to be wrong without knowing it. Two failure patterns dominate:
- An unexplained empty seat. The committee has no physician and no security member, and there is no record of why. A surveyor cannot tell whether the seat was missed or correctly excluded.
- A misread of "employment." A facility seats — or skips — a member based on who works in the building rather than who is employed by the facility, getting the test backwards.
Both are documentation failures more than structural ones, which is good news: they are fixable on paper.
#How to settle the conditional seats correctly
- Determine employment status for each role. Does the facility employ any physicians? Any security-services personnel? Answer each with a yes/no and the supporting fact.
- Seat the member where the answer is yes. Appoint a direct-care physician and/or an employed security-services member and issue appointment documentation.
- Document the exclusion where the answer is no. A brief attestation in the charter — "the facility employs no physicians" or "the security function is contracted; no security-services personnel are employed" — closes the gap.
- Re-check on workforce changes. Hiring an employed physician or bringing security in-house changes the answer; treat committee composition as a monitored status.
A surveyor verifying composition will open the committee charter, the membership roster mapping each seat to a person, the appointment letters, and any attestation explaining a conditional seat left empty.
Facilities that want the charter and Chapter 331-compliant appointment letters drafted turnkey use our policy and plan development service, or stand up the whole committee — including the conditional-seat analysis and minutes — through the workplace violence prevention program. To self-audit first, the Chapter 331 compliance checklist includes the conditional-seat line items.
The conditional seats are simple once you anchor on the employment test: seat the member when the facility employs the role, document the reason when it does not, and revisit the answer whenever your workforce changes.
Sources: Texas Health & Safety Code Chapter 331 (SB 240, 88th Leg., 2023); 26 TAC §133.55; HHSC Provider Letter PL 2024-10. This article is general compliance information, not legal advice.