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Workplace Violence Prevention Compliance by Healthcare Setting
Texas Health & Safety Code Chapter 331 reaches across the care continuum: general and special hospitals, freestanding emergency departments, ambulatory surgical centers, mental hospitals, ICF/IIDs, and state supported living centers are named covered facility classes, while nursing facilities and HCSSAs in every service category are covered once they employ two or more registered nurses. Every covered facility is surveyed on its own. Find your setting below for the obligations, the surveyor questions, and the compliance path tuned to it.
Find your facility
Nine settings, one defensible program
Healthcare Systems
Multi-site programs standardized across every covered facility class.
See compliance path →Hospitals
Covered under HSC Ch. 331 & 26 TAC §505.55: 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 →Behavioral Health Facilities
Concentrated behavioral risk; plan must reflect this population, not generic threats.
See compliance path →Ambulatory Surgery Centers (ASCs)
A named covered facility class under HSC Ch. 331.
See compliance path →Clinics & Medical Groups
Private physician practices are excluded from Ch. 331; TJC/OSHA best practice still applies.
See compliance path →Long-Term Care & Nursing Facilities
Nursing facilities are covered if they employ two or more registered nurses; assisted living facilities are not covered.
See compliance path →Home Health & Hospice (HCSSA)
Covered by Ch. 331 (any service category since SB 463) when the agency employs two or more RNs.
See compliance path →Intermediate Care Facilities (ICF/IID)
Newly covered by SB 463: full Chapter 331 program required since September 1, 2026.
See compliance path →How coverage works
How Chapter 331 decides who is covered
Named covered classes
Hospitals (general and special), freestanding emergency departments, ambulatory surgical centers, and mental hospitals are covered by facility class; coverage does not turn on size or acuity. If you operate one of these, you have been required to maintain a written program since September 1, 2024. ICF/IIDs and state supported living centers, added by SB 463, are also covered by class and had to comply by September 1, 2026.
The two-RN threshold
Nursing facilities and HCSSAs in every service category (since SB 463) are covered once they employ two or more registered nurses. The statute does not define who counts as employed or limit the count to nurses in direct-care roles, so count every registered nurse on the payroll and document the result.
Excluded, but check anyway
Private physician practices are excluded from Chapter 331. But Joint Commission accreditation, payer contracts, OSHA’s General Duty Clause, or a hospital affiliation can still require a program, and a practice operating as a hospital outpatient department may fall under the hospital’s plan.
Coverage FAQ
Frequently asked questions
Which Texas healthcare facilities are covered by Chapter 331?
Eight classes since SB 463 took effect September 1, 2025. General and special hospitals, freestanding emergency medical care facilities (FSEDs), ambulatory surgical centers, mental hospitals, ICF/IIDs, and state supported living centers are covered by class. Nursing facilities and HCSSAs in every service category are covered once they employ two or more registered nurses. Private physician practices are excluded.
Is each facility in a health system surveyed separately?
Yes. Coverage and licensure surveys are facility-by-facility, not system-wide. A health care system may use a single committee for all of its facilities under Section 331.002(d), but only if that committee develops a plan for implementation at each facility and violence prevention data stays distinctly identifiable for each facility. One uniform template plan with nothing facility-specific is the weak point: each covered facility still needs a plan implemented and evaluated for its own setting.
What if my facility class is not on the list?
A class that is not on the list is not covered by Chapter 331 at any staffing level; the two-registered-nurse threshold applies only to HCSSAs and nursing facilities. A Joint Commission or payer requirement, or a hospital affiliation, can still call for a program. A Survey-Readiness Audit confirms your covered-versus-excluded status and documents it.
Not sure whether your facility is covered?
A Survey-Readiness Audit confirms your covered status and scores your committee, plan, training, and governing-body reporting against Chapter 331, the Joint Commission, and OSHA.