OSHA Compliance
The Proposed Federal OSHA Healthcare WVP Rule in 2026
OSHA's healthcare workplace violence rulemaking is still active. Here is where the proposed federal rule stands in 2026 and how to prepare without betting your program on it.
OSHA's healthcare workplace violence rulemaking is still active, not shelved. The SBREFA small-business review panel concluded in March 2023, and OSHA's regulatory agenda has listed a proposed rule anticipated in April 2026 addressing Type II violence by patients, clients, and visitors in healthcare and social assistance. Treat the date as a target, not settled law.
#Where the rulemaking actually stands
For years the federal healthcare workplace violence rule was described as dormant. That framing is outdated. The rulemaking remains on OSHA's regulatory agenda, and the procedural milestones have moved:
- The SBREFA panel — the Small Business Regulatory Enforcement Fairness Act review that precedes a major OSHA proposal — concluded in March 2023 (Source: OSHA Workplace Violence SBREFA).
- OSHA's regulatory agenda has listed a proposed rule anticipated April 2026, scoped to Type II violence — violence by patients, clients, and visitors against workers — in healthcare and social assistance.
The honest caveat: an agenda date is a target, not a published rule. Rulemaking timelines slip, and a proposed rule is followed by a comment period and a final rule before anything is enforceable. Plan around the trajectory, not a specific calendar date.
#Why you should not wait for it
The temptation is to treat a future rule as a reason to delay. That gets the risk exactly backwards. Two enforceable obligations already exist today, independent of any federal rule:
- OSHA's General Duty Clause §5(a)(1) already makes workplace violence a citable recognized hazard for hospitals. Federal data establishing the hazard — a healthcare workplace-violence injury rate roughly 5× the private-sector average in 2018 (BLS, 2018) — is already in the record. A facility with no program is exposed now. See does OSHA require hospitals to prevent workplace violence for how that enforcement works.
- Texas HSC Chapter 331 (the SB 240 mandate) has required covered Texas facilities to maintain a written program since September 1, 2024 — committee, plan, annual training, reporting policy, post-incident response, and an annual evaluation to the governing body.
A future federal rule does not reduce either obligation. It would add a third layer to obligations a Texas facility should already be meeting.
#A national pattern is already forming
The federal rule is not happening in a vacuum. States are enacting their own healthcare workplace violence requirements, which signals the direction a federal standard would likely follow:
| Jurisdiction | Status |
|---|---|
| California (SB 553 / Labor Code §6401.9) | Effective July 1, 2024 — WVP plan, training, and a violent-incident log for nearly all employers |
| Ohio (HB 452) | Signed January 8, 2025, effective April 9, 2025 — hospital security/WVP plans with frontline input |
| New York | Signed December 12, 2025 — hospital and nursing-home WVP plans (verify final effective date) |
| Texas (HSC Chapter 331) | Effective September 1, 2024 — the covered-facility mandate |
(Sources: state statutes and law-firm summaries via Ogletree.) The common spine across every one of these is the same: a written plan, a worksite analysis, training, recordkeeping, and periodic review.
#What a federal rule would likely require
No proposed rule text is final, so specifics are not yet citable. But the consistent structure across OSHA Publication 3148, Chapter 331, and the state statutes above points to a predictable core. A federal rule would most likely require:
- A written workplace violence prevention program
- A worksite analysis with hazard identification
- Hazard prevention and controls
- Training for affected staff
- Recordkeeping and a periodic program evaluation
That is the five-component Publication 3148 framework. A facility already built to those five components would adapt to a federal rule, not start over.
#How to prepare without betting on the timing
The right posture is to build the program you already owe under §5(a)(1) and Chapter 331, structured so it absorbs a future rule with minimal rework:
- Build to OSHA Publication 3148 now — the five components are the through-line across every existing and anticipated regime.
- Keep the program a living record through an annual program review, so adding a new requirement is an update, not a rebuild.
- Watch the rulemaking as upside, not a dependency — a facility waiting for the rule is exposed today; a facility with a current program is positioned for tomorrow.
Multi-state operators and healthcare systems carry the most to gain here, because a single program of record built to the common framework scales across jurisdictions.
#Where to start
If your facility's program is incomplete — or nonexistent — the federal rulemaking is a reason to act sooner, not a reason to wait. A flat-fee survey-readiness audit scores your program against OSHA, Chapter 331, and the Joint Commission today, and our OSHA compliance engagement builds the Publication 3148 program that a future federal rule would ask you to have already.