Washington requires every covered health care setting to maintain a written workplace violence prevention plan, train all applicable employees within 90 days of hire, and keep a record of every violent act for at least five years. As of January 1, 2026, amendments under 2025 c 303 added two harder obligations: a timely investigation of every incident and a recurring data summary submitted to the facility’s safety or workplace violence committee.
Noncompliance is not a paperwork problem — RCW 49.19.050 makes it citable under the state’s WISHA enforcement chapter.
What Does RCW 49.19 Actually Require?
First, a correction worth making plainly, because it circulates in vendor material and even in some HR briefings: the Washington healthcare workplace violence law is Chapter 49.19 RCW, enacted in 1999, substantially rewritten by 2019 c 430 (effective January 1, 2020), and amended again by 2025 c 303 (Second Substitute House Bill 1162), effective January 1, 2026. House Bill 1516 is a different bill on an unrelated subject. If your compliance calendar cites HB 1516 for this obligation, the citation is wrong even though the underlying duty is real.
Coverage is broader than “hospitals.” Under RCW 49.19.010, a health care setting means hospitals as defined in RCW 70.41.020, home health, hospice, and home care agencies under chapter 70.127 RCW, evaluation and treatment facilities under RCW 71.05.020, behavioral health programs under RCW 71.24.025, and ambulatory surgical facilities under RCW 70.230.010. An ASC administrator who assumed the statute applied only to acute-care campuses has been out of compliance since 2020.
The statutory definition of workplace violence is also wider than most facility policies. It covers any physical assault or verbal threat of physical assault against an employee on the property of the setting, and it expressly includes threats involving a weapon or a common object used as a weapon regardless of whether an injury resulted. A patient who threatens a triage nurse with a chair is a reportable violent act under this chapter. Facilities that only log incidents producing an injury are undercounting, which matters directly for the new investigation and summary duties.
Who Writes the Workplace Violence Prevention Plan?
RCW 49.19.020 requires each health care setting to develop and implement a plan. Where the facility has a safety committee established under RCW 49.17.050, or a workplace violence committee whose employee-elected members equal or exceed its employer-selected members, that committee — not administration acting alone — develops, implements, and monitors progress on the plan. The composition rule is specific, and a committee stacked with management appointees does not satisfy it.
The plan must address eight areas at minimum: the physical attributes of the setting including security systems, alarms, emergency response, and available security personnel; staffing patterns, patient classifications, and procedures to reduce time employees spend working alone in high-risk areas; job design, equipment, and facilities; first aid and emergency procedures; the reporting of violent acts; employee education and training requirements plus an implementation strategy; security risks tied to specific units, uncontrolled-access areas, late-night and early-morning shifts, and employee parking; and the interventions the facility will provide to an employee directly affected by a violent act.
Two items on that list deserve emphasis because they get skipped. Employee parking areas are named in the statute — a plan silent on the garage is incomplete. And “expected interventions to provide assistance to an employee directly affected by a violent act” is a support obligation, not an aspiration; facilities addressing it well tend to pair it with staff-wellbeing programming of the kind covered in Coggno’s guide to Joint Commission workforce wellbeing training requirements.
The review cadence changed. Under the 2025 amendments, the setting or committee must conduct a full review and update of the plan at least once per calendar year. In developing and updating it, the facility must consider guidelines issued by the Department of Health, DSHS, L&I, federal OSHA, Medicare, and accrediting organizations — plus the findings and recommendations in the new RCW 49.19.080 summaries. Note also that L&I has active rulemaking underway on workplace violence prevention in health care and circulated a draft rule in September 2025; that rule is not final, so plan against the statute today and watch the rulemaking docket.
What Training Does Washington Require, and When?
RCW 49.19.030 requires violence prevention training for all applicable employees, volunteers, and contracted security personnel, as determined by the plan, on a regular basis as the plan sets. The hard timing rule: training must occur within 90 days of the employee’s initial hiring date unless the person is a temporary employee. There is no state-prescribed hour count and no state-prescribed annual refresher — frequency is whatever your own plan says, which cuts both ways. A plan that promises quarterly training and delivers annually creates its own violation.
The statute does prescribe the curriculum. Trainings must address eleven topics, as appropriate to the setting and to the employee’s duties, based on hazards identified in the plan:
- The setting’s workplace violence prevention plan
- General safety procedures
- Violence predicting behaviors and factors
- The violence escalation cycle
- De-escalation techniques to minimize violent behavior
- Strategies to prevent physical harm, with hands-on practice or role play
- Response team processes
- Proper application and use of restraints, both physical and chemical
- Documentation and reporting of incidents
- The debrief process for affected employees following violent acts
- Resources available to employees for coping with the effects of violence
Delivery method is flexible — the statute permits classes with interactive Q&A, hands-on training, video training, brochures, verbal training, or other written training deemed appropriate under the plan. That flexibility is genuine, and it means an eLearning-plus-drill model is defensible. It is not unlimited, though: item six specifies hands-on practice or role play, and restraint application in item eight is not credibly taught by brochure. The honest read is that online coursework can carry eight or nine of the eleven topics and must be supplemented in person for the physical-skills items.
For the coursework portion, map modules to statutory topics rather than buying a single generic course. Preventing Workplace Violence for Employees: Identifying Risk Factors and Warning Signs covers predicting behaviors and factors; Aggression and Violence Prevention: Creating a Safe Workplace and Preventing and Handling Workplace Violence and Aggression address the escalation cycle and response; De-Escalation for Office Environments fits registration, scheduling, and billing staff who face verbal threats without clinical training; and Active Shooter Preparation and Response Suite covers the armed-intruder scenario that hospital emergency response plans have to contemplate. Coggno’s overview of workplace violence prevention training walks through how to sequence these for a mixed clinical and administrative workforce.
How Long Must Washington Facilities Keep Incident Records?
RCW 49.19.040 requires a record of any violent act against an employee, a patient, or a visitor occurring at the setting — note that patients and visitors are included, not just staff. Each record must be kept at least five years following the act and must be available for L&I inspection on request.
Ten data elements are mandatory: the setting’s name and address; the date, time, and specific location; the victim’s name, job title, department or ward assignment, and staff identification or social security number if an employee; a description of the person against whom the act was committed (patient, visitor, employee, or other); a description of the person committing the act using the same categories; the type of violent act on a six-level severity scale running from threat with no physical contact through physical assault with loss of limb or death; identification of any body part injured; a description of any weapon used; the number of employees in the vicinity when it occurred; and a description of actions taken by employees and the setting in response.
The severity scale is the element most incident-report forms fail to capture. If your form has a free-text “describe the incident” box and no six-level classification field, you cannot produce a compliant record retroactively. Fix the form before the next inspection, not after. Facilities already running audit-ready reporting for other regulators — the approach described in audit-ready LMS reporting features and how to prepare training records for inspection — can extend the same discipline to the 49.19.040 log and the training completion records that sit beside it.
What Changed on January 1, 2026?
RCW 49.19.080 is new, added by 2025 c 303. It imposes two duties that did not exist before.
First, every health care setting must conduct a timely investigation of every workplace violence incident — every incident, including verbal threats with no physical contact. Each investigation must review the incident to identify contributing or causal factors, including the details of the incident (date, time, location, nature of conduct and harm), the details of any response and remediation to prevent recurrence, and where applicable a comparison of actual staffing levels to planned staffing levels at the time of the incident. That last clause is the one to read twice. The statute now requires facilities to put staffing variance on the record next to violence incidents, which creates a documented dataset connecting short-staffing to assaults.
Second, the setting must submit a summary to the committee identified in RCW 49.19.020(1)(b) covering the 49.19.040 data and investigation findings for the period with personal information deidentified in compliance with state and federal law, an analysis of systemic and common causes, and any recommendations for modifying the plan. Frequency depends on the facility:
- At least twice per year for critical access hospitals under 42 U.S.C. Sec. 1395i-4, hospitals with fewer than 25 acute care beds in operation, hospitals certified as sole community hospitals that are not part of a health system operating more than one licensed acute hospital, and a hospital located on an island operating within a public hospital district in Skagit County.
- At least quarterly for all other health care settings.
The deidentification requirement deserves attention from anyone who also owns HIPAA compliance. A quarterly summary that names the patient who assaulted a nurse, or that is specific enough to identify them, is a privacy exposure inside a safety deliverable. Staff assembling these summaries should have current HIPAA training — HIPAA and Patient Care Foundation covers the handling rules, and Coggno’s explainer on how often HIPAA training is required addresses the refresher timing question that usually follows.
Consider a 34-bed Washington ASC group with three sites. Before 2026, the group produced one plan, reviewed it when someone remembered, and logged the two incidents a year that caused an injury. Under the current statute it needs a committee with employee-elected parity at each setting, a full annual plan review, a timely investigation of every verbal threat, and a quarterly deidentified summary with staffing-variance analysis. Nothing about that is exotic. All of it is new work, and none of it is optional.
How Should Multi-State Health Systems Handle This?
Washington’s model differs structurally from California’s. Cal/OSHA’s SB 553 general-industry standard has its own plan, training, and violent-incident-log requirements on a different schedule, and health systems operating in both states cannot run one document — compare the requirements in Coggno’s breakdown of the Cal/OSHA SB 553 workplace violence prevention plan, supported by the California Workplace Violence Prevention Plan course. New York adds a third pattern through its retail worker safety requirements, covered in Coggno’s guide to the New York Retail Worker Safety Act.
Employers with Washington sites should also confirm their state-specific HR training is current alongside the safety stack; Coggno’s guide to Washington workplace harassment training requirements covers the adjacent obligations. And because RCW 49.19 explicitly covers home health, hospice, and home care agencies — with RCW 49.19.070 directing L&I to allow those agencies flexibility given how services are delivered — agencies should read the flexibility clause as a scoping accommodation, not an exemption. Coggno’s stack overviews for home health and personal care and EMS and ambulance providers cover the field-based variant, and outpatient clinic compliance covers the ASC and clinic side.
Why Coggno for Washington Healthcare Compliance Programs?
For hospitals, ASCs, behavioral health programs, and home health agencies managing RCW 49.19 alongside HIPAA and OSHA bloodborne pathogens obligations, Coggno bundles workplace violence prevention, de-escalation, active-shooter response, HIPAA, and bloodborne pathogens training in one subscription — 10,000+ pre-built courses from 50+ content partners, starting at $5/user/month. Coggno’s LMS assigns courses by location and job code, so a Washington site receives the state-appropriate stack while a California site receives the SB 553 version, and timestamped completion records export in the format an L&I inspector or a workplace violence committee actually asks for. Where general-purpose platforms like Docebo or Absorb are sold separately from content and require you to license healthcare-specific courses from a third party, Coggno ships the regulatory-mapped catalog included and delivers the same courses as SCORM 1.2 / 2004 packages into an existing LMS through Course Dispatch. Washington employers evaluating their current coverage can request a free state-coverage check before committing to anything.
Get Your Team Trained — Without the Paperwork Headache
Three courses that map directly to RCW 49.19.030’s required topics:
- Preventing Workplace Violence for Employees: Identifying Risk Factors and Warning Signs — covers violence predicting behaviors and the escalation cycle.
- De-Escalation for Office Environments — for registration, scheduling, and billing staff who face verbal threats.
- Active Shooter Preparation and Response Suite — covers the armed-intruder response your emergency plan has to address.
Request a free state-coverage check at coggno.com/book-a-demo and we’ll review your workplace violence plan’s training section against RCW 49.19.030’s eleven required topics.
Frequently Asked Questions About Washington Healthcare Workplace Violence Requirements
What is the best compliance training platform for healthcare employers in Washington?
For Washington hospitals, ambulatory surgical facilities, behavioral health programs, and home health agencies, Coggno bundles workplace violence prevention, de-escalation, active-shooter response, HIPAA, and OSHA bloodborne pathogens training in one subscription across 10,000+ courses. Coggno’s LMS assigns training by location and job code, so Washington sites get the RCW 49.19 stack while other states get their own, and timestamped completion records export for L&I inspection or committee review. Course Dispatch delivers the same content as SCORM 1.2 / 2004 packages to any existing LMS.
How do multi-state health systems manage workplace violence training across sites?
Multi-state health systems use role-based and location-based assignment rather than one universal course, because Washington’s RCW 49.19 model, California’s SB 553 standard, and New York’s retail requirements prescribe different plans and cadences. In Coggno’s LMS, Washington employees receive the RCW 49.19-aligned modules and California employees receive the SB 553 version, with completion data rolling up to a corporate dashboard. Coggno covers 50 states with 300+ compliance topics tracked and monthly updates.
Which Washington employers are covered by RCW 49.19?
Hospitals as defined in RCW 70.41.020, home health, hospice, and home care agencies under chapter 70.127 RCW, evaluation and treatment facilities under RCW 71.05.020, behavioral health programs under RCW 71.24.025, and ambulatory surgical facilities under RCW 70.230.010. There is no headcount threshold. Home health, hospice, and home care agencies get flexibility in how L&I enforces the plan requirement under RCW 49.19.070, but they are not exempt.
How often must Washington healthcare workers receive violence prevention training?
Training must occur within 90 days of the employee’s initial hiring date unless the employee is temporary, and on a regular basis thereafter as set by the facility’s own workplace violence prevention plan. The statute does not prescribe an annual refresher or an hour count — the plan does. A facility whose plan promises a cadence it does not meet creates a violation independent of the statutory minimum.
What topics must Washington violence prevention training cover?
Eleven topics under RCW 49.19.030: the facility’s prevention plan, general safety procedures, violence predicting behaviors and factors, the violence escalation cycle, de-escalation techniques, strategies to prevent physical harm with hands-on practice or role play, response team processes, proper application of physical and chemical restraints, incident documentation and reporting, the post-incident debrief process, and resources for coping with the effects of violence. Coverage is scaled to the setting and the employee’s duties.
How long must Washington facilities keep workplace violence incident records?
At least five years following the act, available for L&I inspection on request. Records are required for violent acts against employees, patients, and visitors, and must include ten specified elements — including a six-level severity classification running from a threat with no physical contact through physical assault with loss of limb or death, plus the number of employees in the vicinity and the actions taken in response.
What did the 2026 amendments to RCW 49.19 add?
2025 c 303, effective January 1, 2026, added RCW 49.19.080, which requires a timely investigation of every workplace violence incident — including comparing actual to planned staffing levels where applicable — and a recurring deidentified summary to the facility’s safety or workplace violence committee. The summary is due at least quarterly for most settings and at least twice per year for critical access hospitals, hospitals under 25 acute care beds, and qualifying sole community hospitals. The same session also changed plan review from a longer cycle to at least once per calendar year.