In December 2025, New York took a major step in addressing one of the most persistent problems in healthcare: workplace violence against hospital and nursing home staff.
Governor Kathy Hochul signed Senate Bill S5294-B into law — the most significant healthcare workplace safety legislation New York has seen in years. If you manage a hospital, nursing home, clinic, or any other healthcare facility in New York City, this law directly affects how you are required to approach security.
This blog breaks down what the law means, what it requires, and what facility administrators need to do right now to ensure their staff are protected and their facility is compliant.
Why This Law Exists
Healthcare workers in New York — and across the country — face rates of workplace violence that are dramatically higher than workers in almost any other industry. Emergency department nurses, nursing home aides, and hospital security staff are routinely exposed to physical assault, verbal threats, and dangerous confrontations with patients, visitors, and individuals in psychiatric crisis.
For years, these incidents were underreported, undertreated as an occupational reality, and addressed inconsistently across facilities. Senate Bill S5294-B exists because that status quo was no longer acceptable.
The law creates formal, enforceable obligations for healthcare employers — not recommendations, not guidelines, but legal requirements with compliance consequences.
What Senate Bill S5294-B Requires
While the full regulatory details will continue to develop as the law is implemented, the core framework establishes requirements around workplace violence prevention that New York healthcare facilities must take seriously. Key areas include:
Workplace violence prevention programs: Facilities are required to have formal, written workplace violence prevention programs in place. These are not generic safety documents — they need to address the specific risks present in your facility, your patient population, and your physical environment.
Risk assessments: The law requires facilities to conduct workplace violence risk assessments — structured evaluations of where and how violence is most likely to occur in your specific setting. An emergency department in a high-volume New York City hospital has a different risk profile than a residential nursing home in a quieter borough, and the assessment needs to reflect that.
Staff training: Healthcare workers must receive training on workplace violence prevention — how to recognize warning signs, how to de-escalate situations, and what to do when a situation escalates beyond de-escalation. This training has to be documented and conducted on a recurring basis, not just at onboarding.
Incident reporting and recordkeeping: Facilities must maintain records of workplace violence incidents, near-misses, and threats. This documentation is not just for internal review — it feeds the risk assessment process and demonstrates compliance to regulators.
Post-incident response: When a workplace violence incident occurs, the law establishes expectations around how facilities respond — including support for affected staff and review of the incident to prevent recurrence.
What This Means for Your Security Program
Senate Bill S5294-B doesn’t just create a paperwork obligation — it creates a direct operational requirement that connects to your security infrastructure.
Your security guards are part of your compliance framework. The officers deployed in your facility are front-line participants in your workplace violence prevention program. They need to be trained to the standard the law requires — not just licensed to stand at a post. De-escalation skills, incident documentation, emergency coordination — these aren’t optional add-ons anymore. They’re compliance requirements.
Your risk assessment drives your guard deployment. The law requires a risk assessment that identifies where violence is most likely to occur. That assessment should directly inform where your security personnel are posted, how many officers you need during high-risk periods like shift changes and overnight hours, and what posts require dedicated coverage versus patrol.
Your incident reports are legal documents. Every security incident report your guards write is now part of a regulated recordkeeping system. Reports need to be detailed, accurate, and retained properly. A security company whose officers write vague or incomplete incident reports creates a compliance liability for your facility.
Your training documentation needs to be current. If a regulator asks for evidence that your security staff received workplace violence prevention training, you need to be able to produce it. Ask your security provider when training was last conducted, what it covered, and how it was documented.
The New York City Healthcare Environment: Why Compliance Is Especially Complex
New York City’s healthcare facilities operate in one of the most demanding environments in the world. Volume alone creates risk — a hospital emergency department in the Bronx or Brooklyn may see hundreds of patients in a single shift, including individuals in psychiatric crisis, under the influence of substances, or accompanied by distressed and sometimes volatile family members.
Add to that the complexity of multi-site operations — a health system that runs hospitals in Manhattan, nursing homes in Queens, and outpatient clinics across all five boroughs — and compliance becomes a significant coordination challenge. Each facility has its own risk profile, its own patient population, and its own physical layout. A single workplace violence prevention program template applied uniformly across all sites will not meet the law’s intent.
Facilities that serve neighborhoods with higher rates of community violence, or that operate large emergency departments with extended wait times, face elevated baseline risk that needs to be reflected in both the risk assessment and the security deployment.
Common Gaps That Leave Facilities Exposed
Even facilities with existing security programs often have gaps that Senate Bill S5294-B will now put under scrutiny:
Guards without healthcare-specific training. A licensed security officer is not automatically a trained healthcare security officer. If your guards haven’t received specific training in de-escalation, patient interaction, HIPAA-aware incident documentation, and emergency coordination with medical staff, your program has a compliance gap.
No formal risk assessment on file. Many facilities rely on informal or outdated security evaluations. The law requires a structured, documented risk assessment — not institutional memory or a walkthrough that was never written down.
Incident reporting that doesn’t capture near-misses. The law’s recordkeeping requirements extend beyond incidents where physical violence occurred. Threats, confrontations that were de-escalated, and near-misses all need to be captured. A reporting culture where staff only document incidents that result in injury is already out of step with what the law requires.
No post-incident review process. When an incident occurs, what happens next? If your answer is “we fill out a report and move on,” your post-incident response process needs work. The law expects facilities to learn from incidents and demonstrate that learning through program adjustments.
Steps to Take Now
If your New York hospital or nursing home hasn’t already begun preparing for Senate Bill S5294-B compliance, here’s where to start:
Review your existing workplace violence prevention program — or create one if you don’t have it. It needs to be written, facility-specific, and signed off by administration.
Conduct or commission a formal security risk assessment — a structured evaluation of your facility’s specific risk factors, not a general security review. This assessment should identify high-risk zones, high-risk time periods, and the patient/visitor populations that create elevated risk.
Audit your security guard training records — confirm that every officer currently deployed in your facility has received de-escalation training, knows your emergency protocols, and is documenting incidents properly.
Establish a formal incident reporting and review process — one that captures threats and near-misses, not just physical assaults, and that includes a structured post-incident review.
Review your security staffing model — does your current deployment reflect where and when risk is highest in your facility? Are your emergency department, overnight shifts, and high-traffic entry points adequately covered?
Working With a Security Partner Who Understands New York Healthcare Compliance
Compliance with Senate Bill S5294-B isn’t something you can delegate entirely to a security company — but your security provider is a critical part of your compliance infrastructure. The officers they deploy in your facility, the training those officers receive, and the documentation they produce are all directly relevant to whether your facility meets the law’s requirements.
Midwestern Security Services provides hospital and nursing home security across New York City, with officers trained specifically for healthcare environments — including de-escalation, patient interaction, HIPAA-aware documentation, and emergency coordination. We work with facility administrators to ensure our deployment reflects your risk assessment findings and supports your workplace violence prevention program.
Learn more about our hospital and nursing home security services in New York or contact us to schedule a security assessment for your facility.
Final Thoughts
Senate Bill S5294-B is not a distant regulatory concern — it’s current law, and New York healthcare facilities are expected to be moving toward compliance now. The facilities that treat this as a paperwork exercise will find themselves exposed. The ones that use it as a prompt to genuinely strengthen their security programs will be better protected, better compliant, and operating with a security infrastructure that actually reflects the risk their staff faces every day.
If you’re not sure where your facility stands, a formal security assessment is the right place to start.
