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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, and mental hospitals are named covered facility classes, while nursing facilities and home health / hospice HCSSAs are covered once they employ two or more registered nurses (the latter through HHSC Provider Letter PL 2024-10). 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
Eight 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
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 →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.
The two-RN threshold
Nursing facilities and home health / hospice HCSSAs are covered once they employ two or more registered nurses — HCSSAs through HHSC Provider Letter PL 2024-10, which defines an employed RN as a current license in a W-2 relationship regardless of duties.
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?
General and special hospitals, freestanding emergency medical care facilities (FSEDs), ambulatory surgical centers, and mental hospitals are named covered classes. Nursing facilities and home health / hospice HCSSAs are covered once they employ two or more registered nurses (HCSSAs via HHSC Provider Letter PL 2024-10). 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 single system-level committee or one uniform template plan is a structural deficiency surveyors cite — each covered facility needs its own facility-specific program and annual evaluation.
What if my facility class is not on the list?
Coverage can still turn on the two-registered-nurse threshold, a Joint Commission or payer requirement, or a hospital affiliation. 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.