Industry SecuritySelf-assessment

Healthcare and Adult-Care Security and Workplace-Violence Checklist

A healthcare and adult-care security checklist helps a multidisciplinary team review workplace-violence governance, access, visitor management, staff assistance, high-risk areas, reporting, trend analysis, emergency communication and patient or resident considerations. It should be completed with clinical, care, safety, human-resources, compliance, facilities and security leaders because security controls must not disrupt treatment, resident rights, accessibility or emergency egress. This page does not provide clinical care, restraint, seclusion, search, medication, elopement or use-of-force instructions and cannot establish OSHA, CMS, Arizona licensing or accreditation compliance. Follow the facility's approved care and emergency plans, and call 911 for immediate danger.

19 checks5 sectionsSources checked July 19, 2026
Why it matters

Use a system view, not a single-control view

OSHA identifies healthcare and social-service work as a setting with significant workplace-violence risk and describes prevention as an ongoing program involving management, workers, worksite analysis, controls, training, records and evaluation.

Hospitals, urgent-care centers and adult-care facilities also have different patient populations, care obligations, privacy rules and emergency requirements. A security measure is useful only when the appropriate clinical and operational leaders confirm it fits the facility.

Before you begin

How to use this checklist

  1. Form a review team that includes leadership, frontline employees, clinical or care staff, safety, human resources, facilities, compliance and security.
  2. Define the facility types and care settings covered; do not assume one procedure fits a hospital emergency department, urgent-care clinic and adult-care residence.
  3. Use policies, training records, incident data, staff input and safe observations as evidence, protecting health and personal information.
  4. Escalate imminent hazards immediately and route clinical, licensing, privacy and restraint questions to qualified leaders rather than answering them through the checklist.
  5. Assign corrective owners, evaluate effectiveness and repeat the review after serious incidents or material operational changes.
Interactive checklist

Answer each question from current evidence

Use Not applicable only when the item genuinely does not apply, and follow the site’s approved escalation process for any urgent condition.

Section 1 of 5

Program leadership and worker participation

A sustainable program needs accountable leadership, multidisciplinary input and protection for good-faith reporting.

01A designated leader and multidisciplinary team oversee the workplace-violence prevention and security program. Priority review item

Evidence to look for: The team should include management, frontline workers and relevant clinical, safety, human-resources, facilities, compliance and security expertise.

02Employees, contractors and security personnel have a clear, accessible way to report threats, assaults, harassment and security concerns without retaliation. Priority review item

Evidence to look for: Confirm reporting channels, urgent escalation and how reports are acknowledged, investigated and supported.

03The program uses incident reports, injury data, employee input and worksite observations to identify patterns and controls.

Evidence to look for: Protect patient, resident and employee information and evaluate near misses as well as completed acts.

04Policies define the respective roles of care staff, security, supervisors, emergency responders and law enforcement. Priority review item

Evidence to look for: The policy should not assign clinical decisions, restraint, medical treatment or law-enforcement powers to unqualified security personnel.

Section 2 of 5

Access and physical environment

Layered controls should support care delivery, accessibility, privacy, egress and staff safety.

05Public, staff, service and restricted-area entrances have documented operating rules appropriate to the care setting.

Evidence to look for: Review hours, credential use, exceptions and emergency access with facilities, clinical and security leaders.

06Visitors, vendors and contractors are verified and directed without collecting or disclosing more health or personal information than the approved process allows.

Evidence to look for: Confirm who may authorize access, when an escort is required and how exceptions are documented.

07Management-selected high-risk areas have suitable communication, access and assistance measures based on worksite analysis. Priority review item

Evidence to look for: Examples may include emergency, behavioral health, intake, medication, cash, isolated work and parking areas; keep sensitive maps restricted.

08Exit routes, responder access and emergency equipment are not obstructed by security controls or routine operations. Priority review item

Evidence to look for: Qualified facility and fire-safety personnel must determine technical and code requirements.

09Parking, arrival, departure and isolated work areas are included in employee safety and assistance planning.

Evidence to look for: Consider lighting, communication, escorts or shuttle processes and staff check-ins based on site risk and actual service capacity.

Section 3 of 5

Prevention, response and staff support

Training and response must reflect each role, patient population and facility policy.

10Workers and contract personnel receive role-specific training on the prevention program, reporting, communication and emergency actions. Priority review item

Evidence to look for: Training should match likely situations and clearly identify tasks reserved for clinical staff, specially trained teams or police.

11Employees can summon help reliably from management-selected high-risk or isolated work areas. Priority review item

Evidence to look for: Use approved tests of radios, phones, alarms or duress systems without triggering unintended dispatch and document failures.

12The response plan prioritizes escape, shelter, emergency notification and coordinated assistance over improvised physical intervention. Priority review item

Evidence to look for: Security actions must remain within training, post orders and lawful authority; immediate threats belong with 911 and responders.

13Employees affected by threats or violence receive timely medical, supervisory, reporting and follow-up support under policy.

Evidence to look for: Confirm injury response, reporting, workers' compensation or employee-assistance pathways without putting health details in the checklist.

Section 4 of 5

Patient and resident safeguards

Security coordination must preserve dignity, lawful rights, care plans and qualified clinical decision-making.

14Patient or resident security needs are addressed through individualized care, supervision and emergency plans created by qualified facility staff. Priority review item

Evidence to look for: Security may receive role-specific instructions but should not diagnose risk or create clinical plans.

15Procedures for missing, wandering or elopement-risk patients and residents identify notifications and search coordination without publishing sensitive details. Priority review item

Evidence to look for: The facility must tailor the procedure to law, licensing, population and care setting; guards follow assigned roles only.

16Security handling of patient, resident, visitor and incident information follows the facility's privacy and minimum-necessary rules. Priority review item

Evidence to look for: Use authorized systems and avoid diagnoses, medication details or unnecessary personal information in general security logs.

Section 5 of 5

Emergency readiness and evaluation

Healthcare readiness must address hazards, communication, continuity, training and testing at the facility level.

17The security plan is coordinated with the facility's all-hazards emergency plan, communication plan and continuity procedures. Priority review item

Evidence to look for: CMS describes risk assessment, policies, communication, training and testing as core emergency-preparedness elements for covered provider types.

18Exercises test security communication and coordination with care teams, facilities, leadership and external responders.

Evidence to look for: Use safe, announced exercises appropriate to the population and capture after-action improvements.

19Program leaders evaluate whether corrective measures actually reduce exposure and improve reporting and response.

Evidence to look for: Review trends, employee feedback, drill results and control performance rather than relying only on the number of reports.

Current result

Complete the checklist to see a summary

Results are informational and do not certify compliance or eliminate risk.

Common mistakes

What can weaken the review

  • Treating workplace violence as only a security-department issue instead of a multidisciplinary prevention program.
  • Using the same procedures for hospitals, urgent care and adult-care settings without clinical and regulatory review.
  • Assigning restraint, treatment, search or law-enforcement decisions to guards through a public checklist.
  • Collecting diagnoses or excessive patient information in a general security log.
  • Counting fewer reports as success without checking whether employees trust and use the reporting system.
Practical questions

Frequently asked questions

Who should complete a healthcare security assessment?

Use a multidisciplinary team with leadership, frontline employees, clinical or care staff, safety, human resources, facilities, compliance and security. Specialized clinical, licensing, privacy, fire and legal questions need their respective qualified reviewers.

Is workplace-violence prevention only the security department's responsibility?

No. OSHA describes effective prevention programs as requiring management commitment, employee involvement, worksite analysis, hazard controls, training, recordkeeping and evaluation. Security is one contributor.

Can this checklist be used to prove OSHA, CMS or Arizona compliance?

No. Requirements depend on employer, provider type, services, licensing and current law. Use current regulator guidance and qualified compliance review; this checklist only supports an initial internal conversation.

What should a contract guard know about patients or residents?

Only the minimum role-specific information needed to perform assigned duties safely and lawfully. Clinical details, diagnoses, care plans and personal information belong in authorized facility systems and are shared according to facility policy.

Should guards physically intervene in a behavioral crisis?

A public checklist cannot authorize that action. The facility must define roles based on law, care setting, clinical leadership, post orders and documented training. Personnel should prioritize safety and call 911 for an immediate threat.

Sources and evidence baseline

These references support the general planning baseline. Site-specific decisions still require the responsible organization and appropriate qualified professionals.

  1. Hospitals: Workplace ViolenceOccupational Safety and Health Administration

    Program elements, worker involvement, worksite analysis, training, reporting, parking and continual evaluation.

  2. Workplace Violence Prevention ProgramsOccupational Safety and Health Administration

    Healthcare and social-service workplace-violence prevention framework and program resources.

  3. Core Emergency Preparedness Rule ElementsCenters for Medicare & Medicaid Services

    Risk assessment, emergency planning, communication, policies, training and testing for covered providers.

  4. Physical Security Considerations for Healthcare FacilitiesCybersecurity and Infrastructure Security Agency

    Layered healthcare physical-security planning, access and personnel considerations.

Source links checked: July 19, 2026

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