Hospital Security

Hospital security is unlike security in any other industry or field and is also more regulated. As such, the hospital security jobs in general can be demanding, frustrating, and exhausting at times. That being the case, during your hiring process the hospital security management and human resources staff must screen the applicants accordingly.

Hospital Security Regulations

What most people do not understand is that one mistake by a security officer could jeopardize the entire health system and put it at risk of substantial fines, and loss of accreditation and reimbursements.

CMS 482.13(e) Standard Restraint or Seclusion

For example, let’s say that a hospital security officer were to handcuff a patient, or use a device like a Taser, baton, or firearm against a patient, even using those devices as intimidation only, that officer may in fact be in violation of federal laws. The Center for Medicare and Medicare Services (a.k.a. CMS) has a rule in place that restricts the use of restraints and to be free from physical or mental abuse, and corporal punishment.

• 482.13(e) Standard: Restraint or seclusion. All patients have the right to be free from physical or mental abuse, and corporal punishment. All patients have the right to be free from restraint or seclusion, of any form, imposed as a means of coercion, discipline, convenience, or retaliation by staff. Restraint or seclusion may only be imposed to ensure the immediate physical safety of the patient, a staff member, or others and must be discontinued at the earliest possible time.

Also

• CMS does not consider the use of weapons in the application of restraint or seclusion as a safe, appropriate health care intervention. For the purposes of this regulation, the term “weapon” includes, but is not limited to, pepper spray, mace, nightsticks, tazers, cattle prods, stun guns, and pistols. Security staff may carry weapons as allowed by hospital policy, and State and Federal law. However, the use of weapons by security staff is considered a law enforcement action, not a health care intervention. CMS does not support the use of weapons by any hospital staff as a means of subduing a patient in order to place that patient in restraint or seclusion. If a weapon is used by security or law enforcement personnel on a person in a hospital (patient, staff, or visitor) to protect people or hospital property from harm, we would expect the situation to be handled as a criminal activity and the perpetrator be placed in the custody of local law enforcement. [1]

Security Training

Trust me when I say that it is critical that security management trains the security staff on all regulations, statutory laws (state or federal), and all accreditation standards so as to ensure that the hospital security staff fully understands what they can and cannot do when it comes to patient rights.

Policy v. Reality

Unfortunately, I have spoken with dozens, if not hundreds, of hospital security officers over the years that had no idea that they could not handcuff a patient. Others admitted that they have tased patients before as well. When asked why they handcuffed a patient, I was told because they were acting out, and/or for the officers’ safety. Taking it a step further I asked if the patient was placed under arrest and turned over to the police, or if they were allowed to remain at the hospital if they calmed down and the cuffs were removed? In the majority of cases the officers stated that once the patient calmed down and were not considered a threat to anyone else or themselves, the officers would remove the handcuffs. Well now, what they were admitting to was in fact a violation of §482.13(e) Standard: Restraint or seclusion.

Two additional points that need to be made here; first when security management was informed of my findings, in several cases they insisted that their officers would not handcuff any patients, as “they know better”. Really, why then would the officers tell me directly that they often handcuff patients? The second point is that the officers did not know what CMS was, or about any restrictions regarding the use of force against a patient.

Security Officer Intent

To be fair, there has been a dramatic rise in the number of physical attacks against security and nursing staff in hospitals, and as such it appears that the security officers are only trying to protect themselves and others, including the patients, when they use physical force on an aggressive patient. I am not condoning their use of force because I did not have all of the facts. However, what I am saying is in the absence of proper training for the officers, which would include understanding the laws, regulations, and restrictions that govern that use of force in healthcare, the officers believed that they were acting in good faith most times. Thus, the onus is on the hospital security management to develop a training program that trains the officers how to properly control and de-escalate physically violent situations.

Hospital Security in the 21^st Century

There was a time that hospitals were considered safe, and, in many cases, hospitals did not have any security officers. While there are still some smaller hospitals that do not have security officers, the number of those facilities are getting fewer and fewer by the year.

Let me be clear, when I said that hospitals used to be considered safe, I am not saying that they are unsafe today. What I am saying is that healthcare, as an industry, has experienced astonishing increases in the number of behavioral health issues and violent outbursts throughout their facilities. In most cases it is the hospital security officers and nurses that are assaulted on a regular basis, and other patients are not usually in immediate risk.

It is a well-known fact in healthcare that there has continually been an elevated risk for the number of workplace violence incidents, however over the course of the last 10+ years those numbers, and the severity of those workplace violence incidents, are setting new records each year.

As a result of the COVID pandemic, and all of the changes that resulted in locking down facilities, our healthcare systems have been tested to the limits and beyond. Staff worked under very stressful conditions and they worked long hours. As a result, we saw where many people changed careers or just quit working all together. Since then, there is still a large part of our population that has not returned to work in many fields, and as a result many of the things we did prior to 2020 for relaxation and to de-compress are still not available to us.

In essence, if this is the new normal, we must ensure that all staff is properly trained and that the training is ongoing and adjusted to meet the new or changing challenges that we face in the healthcare field.

Evaluate Hospital Security Operations

If you are not sure if your security staff is up to the challenge for today’s healthcare risks, or if your hospital’s security management is not keeping up with the changes or monitoring the industry for new best practices that have, and are, developed every year, it is time to assess the entire security department from the top-down. It is very possible that with a review conducted by a hospital security expert, who is unbiased and not affiliated with any security system retailers of guard companies that offer security guard services, your senior management can get a comprehensive assessment of your security program.

An outside security expert can also assist with training your existing security management and officers as well, as it is not always necessary to replace existing staff, it is a matter of training them properly and giving those current employees the tools that they need to keep everyone at your organization safe, and secure.

To get started, give us a call today for a free consultation.

[1] 42 CFR § 482.13