Department of Labor investigation into visiting nurse’s death finds home care agency failed to protect workers against workplace violence

HARTFORD, CT – A federal workplace safety investigation following the death of a licensed practical nurse during an Oct. 28, 2023, home visit in Willimantic, Connecticut, found one of the nation’s largest home-based care providers did not provide adequate safeguards to protect the nurse, Joyce Grayson, and other employees from the dangers of workplace violence. 

The U.S. Department of Labor’s Occupational Safety and Health Administration determined that on or about Oct. 28, 2023, and at times prior, Elara Caring exposed home healthcare employees to workplace violence from patients who exhibited aggressive behavior and were known to pose a risk to others. 

Following its investigation, OSHA cited Jordan Health Care Inc. and New England Home Care Inc., both doing business as Elara Caring, for one willful violation under the agency’s general duty clause. OSHA cited the employer for not developing and implementing adequate measures to protect employees from the ongoing serious hazard of workplace violence. The agency also cited the employer for one other-than-serious violation for not providing work-related injury and illness records to OSHA within four business hours, as required. 

Elara Caring faces $163,627 in proposed penalties. View the citations. 

“Elara Caring failed its legal duty to protect employees from workplace injury by not having effective measures in place to protect employees against a known hazard and it cost a worker her life,” said OSHA Area Director Charles D. McGrevy in Hartford, Connecticut. “For its employees’ well-being, Elara must develop, implement and maintain required safeguards such as a comprehensive workplace violence prevention program. Workplace safety is not a privilege; it is every worker’s right.”

To address workplace violence, employers should have in place a comprehensive workplace violence prevention program. Elements of a plan should include management commitment and employee involvement; implementation of a written program including the establishment, membership and role of a Workplace Violence Safety Committee; analysis of home environments upon new patient admission; hazard prevention and control; training and education, including resources for impacted employees; recordkeeping; and solicitation of employee feedback during the review process.

OSHA also found that Elara Caring could have reduced the hazard of workplace violence by, among other ways, performing root cause analyses on incidents of violence and near misses, providing clinicians with comprehensive background information on patients prior to home visits, providing emergency panic alert buttons to clinicians and developing procedures for the use of safety escorts for visits to patients with high-risk behaviors. 

Elara Caring provides home-based care with over 200 branches in 17 states, including five branches in Connecticut. Its services include skilled home health, hospice care, personal care service, palliative care and behavioral health.

The company has 15 business days from receipt of its citations and penalties to comply, request an informal conference with OSHA’s area director, or contest the findings before the independent Occupational Safety and Health Review Commission.

The Bureau of Labor Statistics reports 849 U.S. workers died in workplace violence incidents in 2022. Learn more about OSHA and protecting employees against workplace violence, including Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, Workplace Violence in Healthcare: Understanding the Challenge and Preventing Workplace Violence: A Road Map for Healthcare Facilities.