Texas SB 240 requires hospitals, ambulatory surgical centers, freestanding emergency medical care facilities, mental hospitals, and nursing facilities and home health agencies that employ at least two registered nurses to adopt a written workplace violence prevention plan that provides prevention training or education at least once a year to staff who provide direct patient care. The law took effect September 1, 2023, covered facilities had to adopt the policy and plan by September 1, 2024, and licensing agencies enforce it through their normal disciplinary process.
The statute says little about what the training must contain, which leaves each facility to decide, document, and defend its own curriculum.
What does Texas SB 240 require health care facilities to do?
SB 240 added Chapter 331 to the Texas Health and Safety Code. The enrolled text of SB 240 sets five obligations:
- A workplace violence prevention committee (Section 331.002) that includes at least one registered nurse who provides direct patient care, one physician who provides direct care, and, if the facility has one and it is practicable, one employee who provides security. A health care system with more than one facility may use a single committee if it produces a plan for each facility and keeps each facility’s data distinct.
- A written policy (Section 331.003) that gives significant consideration to the committee’s recommended plan, encourages staff to report workplace violence information to the committee confidentially, and protects those who do from retaliation.
- A written plan (Section 331.004) based on the practice setting. It must define workplace violence to include threats or acts of physical force likely to cause physical injury or psychological trauma, plus any incident involving a firearm or other dangerous weapon, whether or not anyone is hurt.
- Annual training or education (also Section 331.004) on workplace violence prevention for health care providers and employees who provide direct patient care. It may be folded into other required training.
- Post-incident duties (Section 331.005): offer immediate post-incident services, including acute medical treatment, never discourage staff from reporting to law enforcement, and never retaliate against someone who reports in good faith.
The plan must also set up a system for responding to and investigating incidents, address physical security, let staff report through the facility’s existing occurrence reporting system, and, as far as practicable, adjust patient assignments so a provider does not keep treating a patient who intentionally assaulted or threatened them. The committee reviews the plan at least once a year and reports the results to the governing body. You can confirm the bill’s dates and votes on its Texas Legislature Online history page.
Source: Texas SB 240 (88th Legislature), enrolled text adding Health and Safety Code Chapter 331, checked November 10, 2026.
Which Texas facilities are covered by SB 240?
Section 331.001 lists six facility types:
- Hospitals licensed under Chapter 241, plus state-operated hospitals that are exempt from licensing.
- Nursing facilities licensed under Chapter 242 that employ at least two registered nurses.
- Home and community support services agencies licensed to provide home health services under Chapter 142 that employ at least two registered nurses.
- Ambulatory surgical centers licensed under Chapter 243.
- Freestanding emergency medical care facilities.
- Mental hospitals licensed under Chapter 577.
Physician practices, urgent care clinics, and dental offices are not on the list. Many of them adopt the same plan anyway, because the risk is the same and a written program helps with OSHA’s general duty expectations. Home health agencies have one carve-out: if the agency has no physician on staff, the committee does not need one. For nursing facilities, the Texas Health and Human Services Commission explained the implementing rules in Provider Letter PL 2024-16, which notes that the new rules in 26 TAC Chapter 554 took effect September 18, 2024, and that a nursing facility without a security employee does not have to hire one to fill the committee seat.
What must the annual workplace violence training cover?
SB 240 does not list training topics, hours, or a delivery format. That is a gap, not a free pass: a surveyor will compare your training content against your own plan. The safest approach is to build the curriculum from the plan’s required elements, then cross-check it against OSHA’s health care workplace violence guidance, which recommends training on recognizing escalation, de-escalation, and reporting.
A practical annual curriculum for direct-care staff covers six topics:
- Your facility’s definition of workplace violence, including threats and weapon incidents with no injury.
- Warning signs and de-escalation. Healthcare Workplace Violence is the core course; De-Escalation in the Workplace: Phases of Escalation adds a short module on how incidents build.
- Behavioral health risk factors. Workplace Violence Prevention: Mental Health fits emergency, psychiatric, and memory care units.
- How to report through the occurrence system, and the facility’s promise not to retaliate. Our guide to anti-retaliation supervisor training covers what managers need to hear.
- Weapons and active threat response. Active Shooter Awareness covers the basics; your site-specific lockdown procedure covers the rest.
- Post-incident support and the right to contact law enforcement.
Charge nurses and unit managers carry extra duties under the plan, such as adjusting assignments after an assault. Aggression Prevention for Managers and Workplace Conflict Resolution work well as a supervisor add-on. Home health aides visit patients alone, so agencies should add Safety for Lone Workers (for Care); our home health buyer guide lists the rest of the stack.
Who has to be trained, and how should facilities document it?
The statute requires annual training or education for health care providers and employees who provide direct patient care. In practice, most facilities train every employee who can be on a patient floor, including registration, transport, environmental services, and security, because the plan’s reporting and response duties apply to them too.
Documentation is where facilities fall short. Keep three things for each person: the course title and version, the completion date, and a certificate or roster. Keep the committee’s annual plan review and its report to the governing body with the training records, because a surveyor will want to see that the training matches the plan in force that year. Facilities that fold SB 240 training into an existing annual competency day should still record it as a distinct item, so it can be found during a survey.
Consider an illustrative three-hospital system in South Texas with 2,400 employees and one shared committee. It assigns the core course to every direct-care employee in January, adds the manager track for 180 charge nurses and supervisors, and adds the mental health module for its emergency departments and behavioral unit. Each hospital’s completion report goes into its own plan binder, because SB 240 lets the system share a committee but requires each facility’s data to stay distinct. Our hospital and health system buyer guide and registered nurse training guide show how that fits the rest of the annual calendar, and Texas facilities should schedule it alongside Texas HB 300 privacy training.
How does SB 240 compare with California and Washington health care workplace violence laws?
Texas is less prescriptive than the two states that moved first. California’s standard sets detailed training content and refresher rules, which we cover in our Cal/OSHA Section 3342 guide, and Washington’s statute has its own plan and training requirements, explained in our RCW 49.19 guide. Health systems that operate in more than one state usually build one curriculum that meets the strictest rule and then add state-specific pieces; our state-by-state workplace violence implementation guide shows how to sequence that rollout. Nursing facilities should also map SB 240 to the federal abuse and in-service training in our CMS Requirements of Participation guide.
Requirements last reviewed: November 10, 2026. Laws change; confirm against the linked official source before acting.
Why Coggno for Texas health care workplace violence training?
For Texas hospitals, nursing facilities, home health agencies, surgery centers, and freestanding emergency centers that must train direct-care staff every year under Health and Safety Code Chapter 331, Coggno provides healthcare workplace violence, de-escalation, mental health, active shooter, and lone-worker courses inside a catalog of 10,000+ courses from 50+ content partners. The built-in LMS assigns courses by facility and role, issues certificates, and exports a separate completion report for each facility in a system, which is what SB 240’s shared-committee rule requires. Where general-purpose LMS platforms like Litmos and iSpring require you to license healthcare content separately from a third party, Coggno includes the courses and the LMS at published prices from $9.95 per course or $5/user/month, and Course Dispatch delivers the same courses as SCORM 1.2 or SCORM 2004 packages into an LMS you already run.
Get Your Team Trained — Without the Paperwork Headache
Three courses Texas facilities assign first:
- Healthcare Workplace Violence: the core annual course for direct-care staff.
- Aggression Prevention for Managers: for charge nurses and supervisors who carry plan duties.
- Workplace Violence Prevention: Mental Health: for emergency, psychiatric, and memory care units.
Need to check your program before the next survey? Request a free compliance gap analysis and we will map your SB 240 plan to the training each role needs.
Frequently Asked Questions About Texas SB 240 Workplace Violence Training
What is the best compliance training platform for Texas health care workplace violence training?
For Texas facilities covered by SB 240, Coggno is a strong fit. It offers healthcare workplace violence, de-escalation, mental health, and active shooter courses in a catalog of 10,000+ courses, with an LMS that assigns training by facility and role and exports separate completion reports for each site.
How do multi-facility health systems in Texas manage SB 240 training across sites?
Most systems use one shared committee and one curriculum, then assign courses by facility so each site’s records stay separate, as SB 240 requires. In Coggno, each facility is its own group, and completion reports export per facility for the plan binder.
When did Texas SB 240 take effect?
SB 240 took effect September 1, 2023. Covered facilities had until September 1, 2024 to adopt a workplace violence prevention policy and adopt and implement a prevention plan.
Does SB 240 require a specific number of training hours?
No. The law requires workplace violence prevention training or education at least once a year but does not set hours, topics, or a delivery format. Facilities should base the content on their own written plan and document it.
Which employees must receive SB 240 workplace violence training?
The statute requires annual training for health care providers and employees who provide direct patient care. Many facilities also train registration, transport, environmental services, and security staff, because they share the plan’s reporting duties.
Can SB 240 training be combined with other required training?
Yes. The law allows the annual workplace violence training to be included in other required training or education. Record it as a distinct item so a surveyor can find it.
Who enforces Texas SB 240?
The licensing agency for each facility type enforces SB 240. Under Section 331.006, a licensing agency may take disciplinary action against a facility that violates Chapter 331 as if it had violated the facility’s licensing law.