Due to the nature of the job, home-based care workers face the risk of experiencing workplace violence. It’s paramount for providers to enact measures that will protect these workers and avoid liability for negligence, legal experts caution.
Workplace violence is defined as an act or threat of violence. This ranges from verbal abuse to physical assaults directed toward a person at work or on duty. Such threats can come in the form of racial, psychological or sexual violence, according to the World Health Organization.
Caregivers and clinicians working in the home are in an especially vulnerable position to experience workplace violence. Home-based care workers are typically working alone in a setting that may be unfamiliar and where they aren’t in complete control, private-practice attorney Elizabeth E. Hogue, told Home Health Care News.
About 18% to 65% of home-based care workers have experienced verbal abuse from patients, and between 2.5% and 44% of workers have reported being physically assaulted on the job, according to data reviewed by CDC.
“I’ve heard it all,” Hogue said. “I’ve had [home-based care workers] tell me, ‘The patient regularly grabs me by the hair, slaps me. I’ve told my employer and they don’t do anything about it. They just tell me to keep going back to this home.’”
On their part, providers “owe their employees a duty of reasonable care,” according to Hogue.
In other words, it is up to providers to take reasonable precautions to protect their employees from workplace violence. While this could mean a number of things, it includes terminating services to patients who are violent or threatening violence.
Providers who follow through on ending services for these patients should unilaterally end the provider and client, or patient, relationship. Providers should then give the individual reasonable notice in order to avoid liability for abandonment of patients.
Workplace violence falls under the purview of the Occupational Safety and Health Administration (OSHA). When a home-based care worker is injured due to workplace violence, OSHA may take action against the provider.
In general, the regulatory agency has been increasingly cracking down on home-based care, according to Hogue.
“For years, home-based care sort of flew under the radar,” she said. “Nobody paid much attention to providers, but now home-based care is sort of the care du jour. People, at least, pay lip service to the idea that it’s important, and we need more of it, and it needs more funding. Along with all of those things, undoubtedly comes increased scrutiny.”
In one case, OSHA fined a provider $98,000 for an alleged willful violation of applicable requirements related to exposure to workplace violence. This included physical and sexual assault from a client.
Additionally, a staff member who had previously worked with that client reported them for sexual assault.
“I think the point at which home-based care providers really need to think long and hard about their possible liability is when they know that there has been violence against their field staff, in particular homes, but don’t take any action,” Hogue said.
OSHA determined that this agency failed to protect its staff members and had no system in place for staff members to report threats.
“It’s important for providers to raise awareness,” Hogue said. “Make it clear to employees that whenever they’re threatened, or the target of violence, and it doesn’t really matter who it comes from, it can be the patient, a family member, just somebody in the patient’s home, they need to report it and document it.”
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