Ohio Compliance
Ohio Hospital Workplace Violence Prevention — Both Deadlines Have Passed
HB 452 took effect April 9, 2025. Full implementation was required by July 9, 2025. Ohio hospitals without a compliant security plan, trained personnel, and incident reporting system are already out of compliance.
— HB 452 / The Healthcare Workplace Safety Act
A bipartisan response to a crisis that became impossible to ignore.
Ohio House Bill 452 — the Healthcare Workplace Safety Act — was signed into law by Governor Mike DeWine on January 8, 2025. It took effect April 9, 2025, with full implementation required by July 9, 2025. Both deadlines have now passed.
The bill was sponsored jointly by Representative Andrea White (R-Kettering) and Representative Rachel Baker (D-Cincinnati) — unusual bipartisan authorship that reflects how broadly the underlying problem is recognized across political lines. The legislation was catalyzed in part by the death of Tristin Kate Smith, a Dayton nurse who died by suicide on August 7, 2023, following a serious workplace violence incident. Her father, Ron Smith, attended the bill signing.
HB 452 applies to hospitals and hospital systems in Ohio. It does not apply to other healthcare settings — outpatient clinics, long-term care facilities, home health agencies — though those settings remain subject to federal OSHA's General Duty Clause and should be monitoring Ohio's legislative trajectory closely.
Upon full implementation, each Ohio hospital must submit an attestation of compliance through the Ohio Department of Health's Juvare EMResource platform.
— Compliance Requirements
Six mandatory program elements. All required now.
HB 452 imposes six distinct compliance obligations on covered Ohio hospitals.
A security risk assessment, conducted as the foundation for all other program elements. The assessment must evaluate the specific violence risks and hazards present at the hospital, with particular attention to high-risk areas. Emergency departments and psychiatric departments are specifically identified as priority areas requiring targeted assessment.
A written security plan, developed based on the risk assessment findings. The plan must address prevention of workplace violence and management of aggressive behaviors. It must be developed by an interdisciplinary team — and this requirement is specific: the team must include healthcare employees who provide direct patient care and at least one current or former patient of the hospital. Generic security planning without direct care worker and patient input does not satisfy the requirement.
De-escalation training for security personnel, at a level equivalent to peace officer standards. Ohio HB 452 grants hospital security personnel access to online security training previously available only to Ohio peace officers. This is a meaningful elevation of the training standard — and a meaningful compliance burden for hospitals whose security teams were not trained to that level.
Continuous trained coverage in emergency and psychiatric departments.At least one hospital employee trained in de-escalation practices must be present at all times in the hospital's emergency department and psychiatric department. This is a staffing requirement, not just a training requirement — it imposes a scheduling obligation that must be maintained 24 hours a day, every day.
A workplace violence incident reporting system, with a clear definition of when incidents must be reported to law enforcement. The system must enable tracking and analysis of incidents over time. Records must be maintained and the system must be functional and accessible to relevant staff.
An annual review of the security plan. The plan is not a one-time deliverable — it must be reviewed and evaluated by the hospital system or hospital on an annual basis, with updates made as conditions, staffing, or risk assessments change.
April 9, 2025
HB 452 effective date — law in force
July 9, 2025
Full implementation deadline — both dates have passed
Annual
Security plan review and attestation cycle
— The Planning Process
Who builds the plan matters as much as what's in it.
One of the most operationally significant requirements of HB 452 is the composition of the team that must develop the security plan. The law requires that the plan be developed by a team that includes healthcare employees who provide direct patient care and at least one current or former patient of the hospital.
This requirement reflects the research consensus on effective workplace violence prevention: the people closest to the threat environment — bedside nurses, emergency department technicians, psychiatric unit staff — have the most accurate understanding of where the risks are and what interventions are practical. A security plan developed exclusively by administrators and security directors without direct care worker input is not compliant with HB 452, regardless of how comprehensive it appears on paper.
In practice, this means hospitals must establish a planning process that genuinely involves direct care staff, not one that seeks pro forma sign-off after the plan has already been written. The process should be documented — who participated, in what capacity, what their contributions were — because that documentation is what demonstrates compliance with this specific requirement in the event of an audit or investigation.
— Anti-Retaliation and Civil Immunity
HB 452 protects employees who report and employees who defend themselves.
Ohio HB 452 includes two categories of employee protection that complement the program requirements.
Anti-retaliation. Hospitals are prohibited from discriminating against or retaliating against employees who report workplace violence incidents or participate in investigations. This protection is explicit and applies regardless of the outcome of the investigation or whether the reported incident ultimately results in any finding.
Civil immunity for self-defense. HB 452 grants general civil immunity to individuals who sustain injuries while acting in self-defense or defense of another during an actual or imminent act of workplace violence. This provision addresses a documented deterrent to self-protective action — the fear among healthcare workers that intervening or defending themselves against a violent patient could expose them to civil liability. The immunity provision removes that deterrent.
Additionally, HB 452 requires hospitals to post prominent signage stating that threatening or aggressive behavior toward staff will not be tolerated and may result in removal from the premises or criminal prosecution. This posting requirement applies throughout the hospital, not just in high-risk areas. Staff working in high-risk areas may also wear identification badges displaying only their first name to protect their personal information from potentially dangerous patients or visitors.
— ODH Compliance Verification
Compliance must be affirmatively reported to the state.
Ohio HB 452 is notable among state workplace violence prevention laws for including an affirmative attestation requirement. Each covered hospital must submit an attestation of compliance through the Ohio Department of Health's Juvare EMResource platform — the same system used for emergency management and public health reporting in Ohio.
This requirement has practical implications beyond typical compliance obligations. A hospital that has not submitted an attestation has self-identified as non-compliant in the state's own systems. Unlike a law enforced only through reactive inspections or complaint-triggered investigations, the attestation requirement means the Ohio Department of Health has affirmative visibility into which hospitals have and have not certified compliance.
Hospitals that have not yet submitted their attestation should treat this as the most urgent compliance priority. The attestation process requires access through the ODH Licensure Juvare User/Organization Request form. Legal counsel or compliance staff who are unfamiliar with the EMResource platform should engage technical assistance before attempting to submit.
— The Legislative Trajectory
Hospitals are the beginning, not the end.
HB 452 applies specifically to hospitals and hospital systems. The question Ohio healthcare employers outside the hospital sector should be asking is whether the legislative trajectory continues toward broader coverage.
The available indicators suggest it will. HB 452 includes a provision requiring the Ohio Department of Higher Education and the Ohio Department of Health to survey whether colleges and universities training future healthcare providers are including workplace violence prevention in their curricula — with a report of findings and recommendations due to the General Assembly. That report will create a record of the current state of education and training that can be used to justify expanded legislation.
The national pattern is consistent: general industry legislation tends to follow healthcare mandates, sometimes by a few years and sometimes by a legislative session. Ohio's HB 452 establishes the precedent, the framework, and the enforcement infrastructure that a broader mandate would build on. Non-hospital healthcare employers in Ohio — outpatient clinics, long-term care, behavioral health, home health — should be building programs now that anticipate that expansion rather than waiting for a deadline that may arrive with little warning.
The same is true for general industry Ohio employers watching the national landscape. California, New York, and Virginia (vetoed but moving) have demonstrated that general industry mandates are viable and building momentum. Ohio's employer community should be watching that trajectory.
— The Broader Picture
Ohio joins a growing national mandate.
| California SB-553 | New York RWSA | Ohio HB 452 | |
|---|---|---|---|
| Industries covered | All industries | Retail only | Hospitals only |
| Employer threshold | Most employers | 10+ retail employees | All hospitals/systems |
| Effective date | July 1, 2024 | June 2, 2025 | April 9, 2025 |
| Full implementation | July 1, 2024 | June 2, 2025 | July 9, 2025 |
| Written plan required | Yes — site-specific WVPP | Yes — retail WVP policy | Yes — security plan |
| Interdisciplinary planning team | Recommended | Not specified | Required by law |
| Training mandate | Annual, interactive | Annual or biennial | Annual; peace officer level for security |
| Continuous trained coverage | Not specified | Not specified | Required in ED and psych units 24/7 |
| Incident documentation | Yes — Violent Incident Log | Encouraged | Yes — reporting system required |
| Anti-retaliation | Yes | Yes | Yes |
| Civil immunity for self-defense | No | No | Yes |
| State attestation required | No | No | Yes — ODH Juvare EMResource |
| Annual plan review | Yes | Biennial policy evaluation | Yes |
| Penalty | Up to $158,727 willful | Not yet specified | Not specified |
— Free Resource
Operating in multiple states?
Download our Multi-State Compliance Checklist — Ohio HB 452, Texas SB 240, California SB-553, New York, and Virginia mapped side by side.
— Next step
Ohio hospital? Both deadlines have passed.
If your hospital does not have a compliant security plan, trained personnel in emergency and psychiatric units, and a functioning incident reporting system, you are already out of compliance. The attestation requirement means the Ohio Department of Health knows it. A 30-minute consultation is the fastest way to assess the gap and build a remediation plan.