Who we serve · Long-Term Care & Nursing Facilities
Workplace Violence Prevention for Long-Term Care & Nursing Facilities
Long-term care is squarely covered by the Texas mandate — with one threshold worth knowing. Under Health & Safety Code Chapter 331, a nursing facility (HSC Chapter 242) is covered if it employs two or more registered nurses. If that describes your facility, you have been required to maintain a program since September 1, 2024, and compliance is checked at your licensure survey.
Long-term care carries a distinct risk profile: residents with dementia and behavioral expressions, family-member conflict, lower staffing ratios, and night-shift exposure. A hospital’s plan does not fit a nursing facility, and surveyors know it. VIGILO builds a program tuned to the realities of long-term care.
Where the mandate applies
How Chapter 331 reaches your setting
- A nursing facility (HSC Chapter 242) is covered under HSC Chapter 331 if it employs two or more registered nurses.
- A covered facility has been required since September 1, 2024 to maintain a program; compliance is checked at the licensure survey.
- The risk profile is resident-generated — dementia-related behaviors, sundowning, family conflict, lower staffing ratios, and night-shift exposure — so a hospital plan does not fit.
- Required of every covered facility: committee, facility-specific written plan, at-least-annual training, confidential anti-retaliation reporting, post-incident response, and an annual governing-body evaluation.
- Chapter 331 has no fine schedule; enforcement is a licensure-survey deficiency plus post-incident litigation discovery.
Speaking the language of surveyors
The six questions a surveyor will ask — answered
Surveyors follow a tracer: they pull the thread from policy to plan to committee to training to record to corrective action. This module is organized around exactly what they ask, what they review, and what gets a facility cited.
What surveyors ask
- Do you employ two or more RNs — and have you therefore confirmed you are a covered facility?
- Is your committee properly composed, including a registered nurse who provides direct resident care (and a security-services employee if you employ one)?
- Does your plan address resident-generated risk — dementia-related behaviors, sundowning, and family conflict — rather than generic intruder scenarios?
- Is training delivered annually to a high-turnover, often bilingual workforce?
- Did you complete the annual plan evaluation to your governing body?
What surveyors review
- Confirmation of covered status (the two-RN threshold).
- Committee charter and minutes showing the required RN-direct-care role.
- A plan addressing resident behavioral risk and family-conflict scenarios.
- Training rosters across high-turnover staff.
- The annual evaluation report to the governing body.
Required documentation
| Document | Why surveyors want it |
|---|---|
| Covered-status determination | Documents the two-or-more-RN threshold |
| WVP committee charter + RN-direct-care member | Must reflect direct resident care |
| Resident-risk-specific written plan | Dementia behaviors, family conflict, night-shift exposure |
| Annual training records | Built for turnover — make-up process documented |
| Annual plan evaluation to governing body | Statutory recurring obligation |
Common deficiencies
- Uncertainty about covered status — facilities near the two-RN threshold that never made or documented the determination.
- A borrowed hospital plan that addresses intruders but not the resident-behavioral and family-conflict risk that defines long-term care.
- Training that cannot keep pace with turnover, leaving new staff untrained.
- No Spanish-language option for a workforce that needs one.
- The annual governing-body report skipped entirely.
How to prepare
- Document your covered-status determination so the question is answered before it is asked.
- Build a plan around resident-generated and family-conflict risk, not generic security threats.
- Create a turnover-resilient training process with make-up sessions and orientation coverage.
- Offer bilingual training to match your workforce.
- Calendar the annual evaluation and document it to the governing body.
How VIGILO helps
VIGILO delivers a long-term-care program that fits the setting:
- A covered-status determination documented for your file.
- A committee charter reflecting the required RN-direct-care role, with facilitation and minutes.
- A facility-specific plan built around dementia-related behaviors, family conflict, and night-shift exposure — not a hospital hand-me-down.
- Annual and orientation training, English and Spanish, with a make-up process designed for turnover.
- The annual plan evaluation prepared and documented to your governing body through the Annual Compliance Subscription.
Texas SB 240 compliance
See the full statute breakdown, the covered-facilities matrix, and the implementing rules on our Texas SB 240 compliance hub.
Recommended path
Audit → Foundation → Annual program of record
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 →Serving every covered healthcare facility class across Texas. See all settings we serve →
Long-Term Care & Nursing Facilities compliance FAQ
Frequently asked questions
Are Texas nursing facilities required to have a workplace violence prevention program?
A nursing facility under HSC Chapter 242 is covered by HSC Chapter 331 if it employs two or more registered nurses. A covered facility has been required since September 1, 2024 to maintain a written, facility-specific workplace violence prevention program — committee, plan, at-least-annual training, a confidential anti-retaliation reporting policy, post-incident response, and an annual plan evaluation reported to the governing body — checked at licensure survey.
How is the two-RN threshold determined for long-term care?
Chapter 331 covers a nursing facility that employs two or more registered nurses. Facilities near that threshold should make and document a covered-status determination so the question is settled before a surveyor asks. VIGILO documents that determination for your file.
Why won’t a hospital workplace violence plan work for a nursing facility?
Long-term care carries a distinct risk profile — residents with dementia and behavioral expressions, sundowning, family-member conflict, lower staffing ratios, and night-shift exposure. A borrowed hospital plan that addresses external intruders but not resident-generated and family-conflict risk is a common cited deficiency. VIGILO builds a plan tuned to the realities of long-term care.
What is the most overlooked Chapter 331 step for nursing facilities?
Two: documenting the covered-status determination, and the annual plan evaluation reported to the governing body. Many facilities complete the committee’s annual review but never document that the results were reported to the board — a distinct statutory obligation that surveyors check and that becomes evidence in post-incident litigation discovery.
Would your long-term care & nursing facilities program hold up under survey?
A Survey-Readiness Audit scores your committee, plan, training, and governing-body reporting against Chapter 331, the Joint Commission, and OSHA — in one document.