Workplace Violence

Southwest Care Center is committed to maintaining a safe, secure, and therapeutic environment for team members, patients, visitors, volunteers, contractors, and vendors. Workplace violence in any form is not tolerated.

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Consistent with the Occupational Safety and Health Act (OSHA) General Duty Clause, applicable CMS Conditions of Participation, HRSA risk management expectations for federally qualified health centers (FQHCs), and New Mexico law, Southwest Care Center maintains a comprehensive Workplace Violence Prevention Program designed to prevent, identify, and respond to potential acts of violence.

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Healthcare settings present unique risks due to clinical acuity, behavioral health needs, substance use disorders, emotional distress, and public access. This policy addresses those realities while preserving patient rights and dignity.

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Scope

This policy applies to:

• All team members (clinical and non-clinical)

• Licensed providers

• Volunteers and students

• Patients and visitors

• Contractors and vendors

• All Organization facilities, parking areas, and work-related activities (including home visits and community outreach)

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Definitions

Workplace Violence includes any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site or during work-related activities.

This includes:

• Patient-to-staff violence

• Staff-to-staff violence

• Visitor-to-staff violence

• Domestic violence impacting the workplace

• Threats made verbally, in writing, electronically, or through gestures

 

Zero-Tolerance Standard

Southwest Care Center prohibits:

• Physical assault or attempted assault

• Verbal or written threats

• Intimidation or coercion

• Menacing gestures

• Stalking

• Harassment involving threats of harm

• Intentional damage to property

• Possession, brandishing, or use of weapons on Organization premises or during work activities, to the extent permitted by federal and New Mexico law

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This prohibition applies equally to team members, patients, and visitors.

Nothing in this policy restricts legally protected rights under federal or New Mexico law.

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Prevention and Risk Reduction

Recognizing the elevated risk in healthcare environments, Southwest Care Center implements the following preventive measures:

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1. Environmental and Engineering Controls

• Controlled access points when feasible

• Panic buttons or duress systems where appropriate

• Physical barriers in high-risk areas

• Security camera systems (where installed)

• Room layout considerations to allow safe exit

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2. Administrative Controls

• Incident reporting system

• Behavioral flagging in electronic health records, consistent with HIPAA and patient rights

• De-escalation protocols

• Code response procedures

• Visitor management guidelines

• Coordination with local law enforcement when necessary

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3. Training

Team members will receive training appropriate to their role, which may include:

• Recognizing early warning signs of escalating behavior

• Trauma-informed communication

• De-escalation techniques

• Personal safety strategies

• Active threat response procedures

• Reporting requirements

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Training will occur at onboarding and periodically thereafter, consistent with organizational risk assessment.

 

Warning Signs of Escalation

While not predictive, behaviors that may indicate increased risk include:

• Escalating anger or hostility

• Verbal threats (direct or implied)

• Severe agitation or emotional instability

• Fixation on weapons

• Intimidating or aggressive conduct

• Obsession with a staff member

• Sudden significant behavioral changes

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These indicators should be reported promptly.

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Reporting Procedures

All incidents or threats of workplace violence must be reported immediately.

Reports may be made to:

• Immediate supervisor

• Any member of leadership

• Vice President of Human Resources

• Through the SCC Incident Reporting System

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If there is an immediate threat of harm, team members should call 911 or local law enforcement before submitting an internal report.

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Reports will be handled as confidentially as possible, consistent with a thorough investigation and patient care obligations.

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Failure to report known threats may result in corrective action.

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Response and Investigation

Southwest Care Center will:

• Promptly assess reported threats

• Conduct a timely, good faith investigation

• Implement interim safety measures when necessary

• Take appropriate corrective action

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Corrective action may include:

• Removal of a visitor

• Behavioral contracts with patients

• Clinical reassessment

• Disciplinary action up to and including termination

• Referral to law enforcement

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All team members are required to cooperate in investigations.

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Patient Rights Considerations

When the source of violent behavior is a patient:

• The Organization will balance safety with patient rights and nondiscrimination obligations under federal and New Mexico law.

• Actions will not be based on protected characteristics.

• Clinical interventions will be considered where behavior is linked to medical, psychiatric, or substance-related conditions.

• Termination of a patient relationship will follow established risk management and continuity-of-care procedures when appropriate.

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Domestic Violence Impacting the Workplace

Team members who are subject to domestic violence that may impact workplace safety are encouraged to notify Human Resources or management so protective measures can be implemented.

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Southwest Care Center will comply with applicable New Mexico protections related to victims of domestic abuse and will maintain confidentiality consistent with law.

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Non-Retaliation

Southwest Care Center strictly prohibits retaliation against any individual who, in good faith:

• Reports a threat or incident

• Participates in an investigation

• Assists in safety planning

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Retaliation will result in disciplinary action up to and including termination.

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Program Review and Continuous Improvement

Workplace violence incidents will be periodically reviewed to:

• Identify trends

• Evaluate environmental risks

• Improve training

• Strengthen response protocols

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This review supports continuous quality improvement and compliance with healthcare regulatory expectations.