Texas HSC Chapter 331
The Chapter 331 RN-Direct-Care Committee Seat
Texas HSC Chapter 331 requires a registered nurse who provides direct patient care on your WVP committee. Here is how to fill the seat correctly and document it for survey.
Texas HSC Chapter 331 requires your workplace violence prevention committee to include a registered nurse who provides direct patient care. Unlike the physician and security-services seats — which apply only if the facility employs those roles — the direct-care RN seat is mandatory for every covered facility. It is also the membership requirement a surveyor checks first.
This article goes deeper than the general roster: it explains what "provides direct patient care" actually means, why a nurse executive's RN license is not enough, and the exact documentation that proves the seat is genuinely filled. For the full committee composition, see who must serve on a Chapter 331 WVP committee; for the two conditional seats, see the physician and security-services committee seats. The pillar is Texas SB 240 & HSC Chapter 331 compliance.
#What the statute actually says
Chapter 331 requires the committee to include a registered nurse who provides direct patient care (Texas HSC Chapter 331; SB 240, 88th Leg., 2023). Two words in that phrase carry the weight:
- Registered nurse — the seat is RN-specific, not "a nurse." An LVN/LPN, a paramedic, or a medical assistant does not fill it.
- Provides direct patient care — the nurse must be a frontline clinician who actually treats patients, not someone whose only connection to the floor is a credential.
The legislative purpose is plain: the committee that owns the WVP plan, reviews incident data, and reports to the governing body must keep a genuine frontline clinical voice at the table. Workplace violence in healthcare is overwhelmingly Type II — patient-on-worker — so the person closest to those encounters belongs in the room where controls are designed.
#Why a nurse executive's license is not enough
This is the most common way facilities misfill the seat. A chief nursing officer, a director of quality, or a nurse educator may hold an active RN license — but if they no longer provide direct patient care, they do not satisfy the statutory requirement on title alone.
| Candidate | Fills the seat? | Why |
|---|---|---|
| Bedside RN on a med-surg or ED floor | Yes | Actively provides direct patient care. |
| Charge nurse who still carries patients | Yes | Direct care is part of the role. |
| Nurse manager with a clinical assignment | Usually | Defensible if direct-care duties are real and documented. |
| CNO / VP of Nursing (administrative only) | No | RN license, but no direct patient care. |
| Quality or compliance RN (no patient contact) | No | License without direct care does not satisfy the seat. |
The practical test a surveyor applies is not the person's title but whether the record shows they provide direct patient care. A CNO can absolutely sit on the committee — and often should — but they cannot be the direct-care RN seat. Seat both: the executive for authority, a true bedside RN for the statutory requirement.
#The seat that surveyors check first
Across Texas licensure surveys, the missing or mis-filled RN-direct-care seat is the single most frequent committee deficiency. It is easy to cite because it is binary and documentary: either the roster shows a registered nurse providing direct patient care, with a role description that backs it up, or it does not.
Because the deficiency turns on documentation rather than judgment, it is also entirely preventable. The fix is never complicated — it is almost always a matter of having captured the member's direct-care role in writing before the surveyor arrives.
#What documentation proves the seat is filled
A surveyor verifies the RN-direct-care seat through the paper trail, not a conversation. Keep the following in your survey-readiness binder:
- Committee roster that names the RN and maps them to the "registered nurse providing direct patient care" category specifically — not just "nurse."
- Appointment letter or record for that member, stating their direct-care role (unit, position, that they actively treat patients).
- Meeting minutes showing the member participates, which corroborates that the seat is real and not a name on a chart.
If your direct-care RN rotates or leaves, re-seat and re-document promptly. A vacant or stale RN seat is the same deficiency as never having filled it. Treat the seat as a standing role, not a one-time appointment.
#How to fill the seat correctly
- Identify a genuine direct-care RN — a clinician who actively treats patients at your facility, ideally on a high-risk unit such as the emergency department where Type II violence concentrates.
- Capture their direct-care role in the appointment record, in plain language a surveyor can read in seconds.
- Keep the executive seat separate. Put the CNO or nursing director on the committee in their own capacity, so the bedside RN clearly occupies the statutory seat.
- Map the roster to the statute. Each required category — direct-care RN (mandatory), physician and security-services (conditional) — should line up against a named member.
- Minute the member's participation so the trailing-twelve-months record shows the seat is active.
Facilities that want this stood up turnkey use our policy and plan development service, which drafts the committee charter and Chapter 331-compliant appointment letters that document the direct-care RN role correctly, or the full workplace violence prevention program, which seats and minutes the committee end to end. To self-check first, the Chapter 331 compliance checklist includes the committee-composition line items, and a survey-readiness audit scores whether your roster and appointment records would hold up.
The RN-direct-care seat is small to fill and easy to get wrong on a technicality. Anchor it on a real bedside clinician, document the direct-care role in writing, and keep the seat current — and the most-cited committee finding in Texas simply never appears in your survey.
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.