A federal appeals court on Feb. 13 affirmed that Cedar Springs Hospital in Colorado Springs failed to protect staff from repeated incidents of patient-on-staff violence, leaving in place more than $15,000 in fines. The unanimous 3-0 ruling keeps alive an administrative law judge’s finding that multiple feasible safety measures were available but not implemented. For employees and families near Cheyenne Mountain, the decision puts a sharp point on long-running tensions between patient care and worker safety at high-acuity psychiatric facilities.
Judge Robert E. Bacharach wrote the opinion for a three-judge panel that also included Judges Timothy M. Tymkovich and Gregory A. Phillips. The court concluded the Department of Labor had authority to enforce the general duty clause against the hospital and rejected several of Cedar Springs’ legal challenges, according to the U.S. Court of Appeals for the Tenth Circuit.
An Occupational Safety and Health Review Commission administrative law judge, Christopher D. Helms, held a multi-day hearing in February 2022 and assessed a $13,494 penalty for a serious general-duty violation and a $1,928 penalty for recordkeeping failures, according to the Occupational Safety and Health Review Commission.
The appellate court accepted the judge’s view that several straightforward fixes, including reconfiguring nurses’ stations, adding staff or dedicated security personnel, providing radios and silent communication devices, and securing patients’ belongings, would have materially reduced the hazard, per the court’s published opinion. The panel found substantial evidence that those measures were feasible and would have meaningfully lowered the risk to staff.
Cedar Springs, which operates multiple buildings and treats up to 110 patients, many admitted involuntarily, argued on appeal that oversight by the Centers for Medicare & Medicaid Services and accreditation guidance displaced OSHA and that the citation lacked fair notice about what the hospital had to do to comply. Attorney Dion Y. Kohler told the panel there was "a serious fair notice problem about what it is we’re supposed to do to comply," as reported by Colorado Politics.
Legal implications
Legal analysts say the ruling narrows a common defense for hospitals that lean on CMS oversight and accreditation to avoid OSHA enforcement and strengthens the agency’s ability to use the general duty clause in healthcare settings. A legal review by Husch Blackwell notes the decision rejects displacement and notice claims and will likely push hospitals and management companies to re-evaluate violence-prevention programs and recordkeeping practices.
What’s next
The Tenth Circuit issued a published opinion on Feb. 13; unless Cedar Springs asks for rehearing en banc or the Supreme Court agrees to review the case, the penalties and the finding will stand. Case summaries and the public docket provide the full opinion and timeline for the dispute and now serve as a reference point for other psychiatric hospitals facing workplace-violence citations, per the case record on Justia.
