Texas SB 240 · HSC Chapter 331
Texas SB 240 Workplace Violence Prevention Compliance (HSC Chapter 331)
Texas SB 240 (88th Legislature, 2023) added Chapter 331 to the Health & Safety Code, requiring covered healthcare facilities to adopt a written workplace violence prevention program by September 1, 2024. It mandates a committee, a facility-specific plan, at-least-annual training, a confidential anti-retaliation reporting policy, post-incident response, and an annual plan evaluation reported to the governing body.
Honest framing: Chapter 331 carries no dedicated fine schedule. The exposure is a licensure-survey deficiency and post-incident litigation discovery — never a statutory fine.
On this page
Section 01
What is SB 240 and HSC Chapter 331?
Senate Bill 240, passed by the 88th Texas Legislature in 2023, created Chapter 331 of the Texas Health & Safety Code — the state’s first dedicated workplace violence prevention (WVP) mandate for healthcare facilities. The statute took effect September 15, 2023, and gave covered facilities until September 1, 2024 to adopt and implement a written WVP policy and plan.
Chapter 331 does not stand alone. The Texas Health and Human Services Commission (HHSC) hard-wired it into licensure through 26 TAC §133.55, the hospital rule adopted in the Texas Register on October 11, 2024, and through Provider Letter PL 2024-10 (Revised) for home health and hospice agencies. Together they convert a statute into something a licensing surveyor checks against during your survey.
For most covered facilities, the same program can satisfy three regimes at once — Chapter 331, the Joint Commission’s workplace violence prevention requirements (effective January 1, 2022 for hospitals), and OSHA’s General Duty Clause and Publication 3148. VIGILO builds one survey-readiness binder engineered to hold up under all three.
Section 02
Who is covered by Chapter 331?
Chapter 331 applies to a defined set of licensed healthcare facility classes. Two of those classes — nursing facilities and home & community support services agencies (HCSSAs) — are covered only when they employ two or more registered nurses. Private physician practices are not covered.
| General & special hospitals (HSC Ch. 241) | Covered; enforced through 26 TAC §133.55. |
|---|---|
| Mental hospitals (HSC Ch. 577) | Covered. |
| Ambulatory surgical centers / ASCs (HSC Ch. 243) | Covered. |
| Freestanding emergency medical care facilities (FSEDs) | Covered — a named facility class. |
| Nursing facilities (HSC Ch. 242) | Covered only if the facility employs two or more registered nurses. |
| HCSSAs — home health & hospice (HSC Ch. 142) | Covered via PL 2024-10 when the agency employs two or more registered nurses. |
| Private physician practices | Excluded from Chapter 331. Joint Commission / OSHA best practice may still apply. |
For HCSSAs, PL 2024-10 clarifies that an "employed RN" means a current Texas RN license plus a W-2 employment relationship — regardless of the nurse’s job duties.
Section 03
The six required program elements
Chapter 331 specifies the program a covered facility must build and maintain. A surveyor checks each element, and an incomplete committee or a missing governing-body report is among the most commonly cited gaps.
- WVP committee — must include a registered nurse who provides direct patient care; a physician who provides direct patient care if the facility employs any; and a security-services employee if the facility employs any. An existing committee may be re-authorized.
- Written, facility-specific WVP policy and plan — named to your facility, units, and risks, not a purchased template.
- Employee training at least annually — for all applicable staff, documented with completion records.
- Confidential reporting policy with anti-retaliation protection — the facility cannot discipline, discriminate, or retaliate against a good-faith reporter, and cannot discourage staff from contacting law enforcement.
- Post-incident response — offer immediate post-incident services, including any necessary acute medical treatment, to staff directly involved, and adjust work assignments as appropriate.
- Annual plan evaluation reported to the governing body — the committee meets at least annually to evaluate the plan and reports the results to the facility’s governing body. This is the single most overlooked step.
Section 04
What are the penalties for non-compliance?
Chapter 331 carries no dedicated fine or citation-penalty schedule. Non-compliance does not generate a statutory fine. That is precisely why the exposure is easy to under-weight — and why it is real.
Non-compliance surfaces in two ways. First, as a licensure-survey deficiency: HHSC checks Chapter 331 at the licensure or re-licensure survey, and a missing element becomes a statement of deficiencies requiring a plan of correction, with the licensing agency able to take disciplinary action against the license. Second, and often more consequential, as post-incident litigation discovery: after a serious assault, plaintiffs’ counsel will ask whether the facility had a compliant plan, followed it, trained staff, and reported the annual evaluation to the board. The documentation is the defense.
VIGILO never frames Chapter 331 urgency around fictional fines. Urgency is survey-readiness and litigation exposure, accurately stated.
Section 05
Why compliance is an annual obligation, not a one-time project
The statute renews by design. The committee’s annual plan evaluation and governing-body report, at-least-annual training, and the worksite analysis the plan depends on all recur every year. A program that was compliant the day it was adopted drifts out of compliance the moment a survey calendar turns over without the annual evaluation being documented and reported to the board.
This is the same recurrence that lets one program serve three regimes: Chapter 331’s annual evaluation, the Joint Commission’s annual worksite analysis and training, and OSHA Publication 3148’s periodic program evaluation are all written into the rules. VIGILO’s annual program reviews carry that renewing obligation as a managed program of record.
Section 06
One binder, three regimes
A central efficiency for Texas facilities: a single, well-built program can answer Chapter 331, the Joint Commission, and OSHA at the same time. The elements map cleanly across regimes.
| Leadership / governance | Ch. 331 committee + governing-body report · TJC designated program leader (LD) · OSHA management commitment (Component 1). |
|---|---|
| Worksite / risk analysis | Ch. 331 facility-specific plan basis · TJC annual worksite analysis (EC) · OSHA worksite analysis (Component 2). |
| Training | Ch. 331 at least annually · TJC orientation + annual + on-change (HR) · OSHA safety & health training (Component 4). |
| Reporting & data | Ch. 331 confidential + anti-retaliation policy · TJC reporting, tracking, trending (EC) · OSHA recordkeeping + the OSHA 300 Log (Component 5). |
| Post-incident | Ch. 331 acute treatment + assignment adjustment · TJC post-incident strategies (EC) · OSHA recordkeeping / evaluation (Component 5). |
| Evaluation | Ch. 331 annual evaluation to governing body · TJC leadership review of data · OSHA program evaluation (Component 5). |
Section 07
Go deeper: the Chapter 331 rule set
This hub links to the three primary sources that make Chapter 331 enforceable in the field. Start with the statute, then move to the rule that governs your facility class.
- HSC Chapter 331 requirements — the statute itself: covered facilities, committee composition, and the six elements, in detail.
- 26 TAC §133.55 (hospitals) — the HHSC hospital rule adopted October 2024 and how it is checked at the licensure survey.
- HCSSA PL 2024-10 (home health & hospice) — how Chapter 331 reaches home health and hospice agencies, and the two-RN trigger.
Section 08
How VIGILO helps you comply
VIGILO is a healthcare compliance, training, and consulting firm. We build and maintain the survey-defensible WVP program and documentation Chapter 331 requires. We are not a security-guard, patrol, or investigations company; "security" appears here only in compliance contexts, such as the security-services committee member.
- Start with a survey-readiness audit — a scored gap report against the Chapter 331, 26 TAC §133.55, PL 2024-10, and Joint Commission checklist.
- Build the program with a workplace violence prevention program: the facility-specific plan, committee charter and appointment letters, reporting and anti-retaliation policy, and initial all-staff training.
- Keep it current with annual program reviews that run the annual evaluation, governing-body report, and training refresh — every year.
- Find your facility class on who we serve, from hospitals and emergency departments to long-term care and home health & hospice.
Key dates
The SB 240 / Chapter 331 timeline
- June 2023
SB 240 enacted
The 88th Texas Legislature passes Senate Bill 240, adding Chapter 331 (Workplace Violence Prevention) to the Health & Safety Code.
- Sept. 15, 2023
Statute effective
HSC Chapter 331 takes effect, beginning the runway to the implementation deadline.
- Sept. 1, 2024
Compliance deadline
Covered facilities must have adopted and implemented a written WVP policy and plan — committee, training, reporting policy, and post-incident response in place.
- Oct. 11, 2024
26 TAC §133.55 adopted
HHSC publishes the adopted hospital rule in the Texas Register (Vol. 49, No. 41), hard-wiring Chapter 331 into the hospital licensure survey.
- 2024 (revised)
HCSSA PL 2024-10
HHSC issues Provider Letter PL 2024-10 (Revised), applying Chapter 331 to licensed and certified home health and hospice agencies that employ two or more registered nurses.
- Annually, thereafter
Recurring obligation
The committee must evaluate the plan at least annually and report the results to the governing body — a renewing statutory duty, not a one-time project.
The Chapter 331 rule set
Go deeper: the three primary sources
Each subpage traces one instrument that makes Chapter 331 enforceable in the field — the statute, the hospital rule, and the home-health/hospice provider letter.
Primary source
HSC Chapter 331 Requirements: Texas Workplace Violence Prevention
The Texas HSC Chapter 331 workplace violence prevention requirements explained: covered facilities, committee composition, the written plan, training, reporting, and the annual evaluation.
Read the breakdown →Primary source
26 TAC §133.55: The Texas Hospital Workplace Violence Prevention Rule
How 26 TAC §133.55 implements HSC Chapter 331 for Texas hospitals: what the rule requires, when it was adopted, and how HHSC surveyors check it at the licensure survey.
Read the breakdown →Primary source
HCSSA PL 2024-10: Chapter 331 for Home Health & Hospice
How HHSC Provider Letter PL 2024-10 applies Texas HSC Chapter 331 to home health and hospice agencies (HCSSAs) that employ two or more RNs — the two-RN trigger, requirements, and deadlines.
Read the breakdown →Find your obligation
Coverage by facility class
Coverage and committee composition vary by facility type. Start with your class, then map it back to the six required elements above.
Hospitals
Covered under HSC Ch. 331 & 26 TAC §133.55 — committee, plan, training, annual evaluation.
See compliance path →Emergency Departments & FSEDs
Highest-risk units; FSEDs are a named covered facility class under Ch. 331.
See compliance path →Long-Term Care & Nursing Facilities
Covered if the facility employs two or more registered nurses.
See compliance path →Home Health & Hospice (HCSSA)
Covered via PL 2024-10 when the agency employs two or more registered nurses.
See compliance path →Not listed here? See every facility class we serve →
How VIGILO helps
Assess → Build → Sustain
VIGILO is a healthcare compliance, training, and consulting firm — not a security-guard or patrol company. We build and maintain the survey-defensible program and documentation Chapter 331 requires.
Survey-Readiness Audit
A scored gap report against the Chapter 331 / 26 TAC §133.55 / PL 2024-10 / Joint Commission checklist.
Flat fee · $500–$1,500
Details →Workplace Violence Prevention Programs
The complete, facility-specific program of record — committee, plan, training, and binder.
Flat fee · $2,500–$6,000
Details →Annual Program Reviews
Your Chapter 331 program of record: annual evaluation, training refresh, and committee support.
Subscription · $1,500–$3,600 / yr per site
Details →Primary sources
- Texas Health & Safety Code Chapter 331 — Workplace Violence Prevention (added by SB 240, 88th Legislature, 2023).
- 26 TAC §133.55 — Workplace Violence Prevention (general & special hospitals); adopted Texas Register Oct. 11, 2024 (Vol. 49, No. 41).
- HHSC Provider Letter PL 2024-10 (Revised) — application of Chapter 331 to home health and hospice HCSSAs.
- The Joint Commission Workplace Violence Prevention requirements (R3 Report Issue 45; EC/HR/LD chapters, effective Jan. 1, 2022 for hospitals).
- OSHA General Duty Clause §5(a)(1); OSHA Publication 3148; enforcement directive CPL 02-01-058.
Texas SB 240 FAQ
Frequently asked questions
What is Texas SB 240?
SB 240 is a 2023 bill from the 88th Texas Legislature that added Chapter 331 to the Texas Health & Safety Code. Chapter 331 requires covered healthcare facilities to adopt and implement a written workplace violence prevention program — a committee, a facility-specific plan, at-least-annual training, a confidential anti-retaliation reporting policy, post-incident response, and an annual plan evaluation reported to the governing body — no later than September 1, 2024.
Which facilities must comply with HSC Chapter 331?
General and special hospitals, mental hospitals, ambulatory surgical centers, and freestanding emergency medical care facilities are covered. Nursing facilities and home health/hospice agencies (HCSSAs) are covered only if they employ two or more registered nurses. Private physician practices are excluded. Hospital compliance is enforced through 26 TAC §133.55; home health and hospice through HHSC Provider Letter PL 2024-10.
What are the penalties for not complying with Chapter 331?
Chapter 331 has no dedicated fine schedule. Non-compliance surfaces as a deficiency at the HHSC licensure survey — requiring a plan of correction, with possible disciplinary action against the license — and as a discovery target in post-incident litigation after a serious assault. The urgency is survey-readiness and litigation exposure, not fines.
When was the Chapter 331 compliance deadline?
Covered facilities had to adopt and implement a written workplace violence prevention policy and plan no later than September 1, 2024. The statute itself took effect September 15, 2023, and the HHSC hospital rule (26 TAC §133.55) was adopted in the Texas Register on October 11, 2024. Compliance is an ongoing, annual obligation thereafter.
Does a Chapter 331 program also satisfy the Joint Commission and OSHA?
It can, if built that way. The program elements map across all three regimes: Chapter 331’s committee and annual evaluation, the Joint Commission’s designated leader, annual worksite analysis, and incident trending (effective January 1, 2022 for hospitals), and OSHA’s five Publication 3148 components under the General Duty Clause. VIGILO builds one survey-readiness binder engineered to answer all three.
Who must serve on the Chapter 331 workplace violence prevention committee?
The committee must include a registered nurse who provides direct patient care; a physician who provides direct patient care if the facility employs any; and a security-services employee if the facility employs any. A facility may re-authorize an existing committee. A committee missing a required member category — most often the RN providing direct care or the physician — is a common cited deficiency.
Is your Chapter 331 program survey-defensible?
A Survey-Readiness Audit scores your committee, plan, training, reporting policy, and governing-body evaluation against Chapter 331, 26 TAC §133.55, PL 2024-10, and the Joint Commission — in one document.