In a February 13, 2026 decision, Cedar Springs Hospital v. Occupational Safety and Health Review Commission (OSHRC), No. 24-9519 (10th Cir. 2026), the Tenth Circuit U.S. Court of Appeals reaffirmed the Occupational Health and Safety Administration’s (OSHA) authority to cite healthcare employers for workplace violence under the OSHA’s General Duty Clause. The court upheld OSHA citations issued to a Colorado psychiatric hospital, as well as related penalties against the hospital’s management company based on common ownership. The court rejected three main arguments posited by the hospital.

The hospital argued that OSHA lacked authority because the Centers for Medicare and Medicaid Services (CMS) already has authority over hospital employee safety. The court rejected that argument, holding that CMS’ oversight of patient safety does not displace OSHA’s independent responsibility to protect employee safety. And since CMS’ regulations do not govern employee safety, OSHA remained free to enforce the General Duty Clause to protect employees.

The court also rejected claims that OSHA was required to issue a formal workplace violence standard before enforcing the law. Courts generally defer to agencies in their discretion to proceed through adjudication rather than rulemaking, and even if OSHA should have engaged in rulemaking, this does not relieve the hospital’s duty to address recognized hazards.

The court upheld OSHRC’s reliance on OSHA guidance documents, finding they were used appropriately to establish that workplace violence is a recognized hazard and that feasible abatement measures exist. The court further held that the hospital was given fair notice, even though some abatement measures were described in general terms.

This decision, along with UHS of Delaware v. OSHRC, No. 24-9521 (10th Cir. 2026), strengthens OSHA’s use of the General Duty Clause to enforce workplace violence violations, as opposed to how OSHA has fared in using this clause to issues citations concerning heat stress and heat-related illness. Please contact a Husch Blackwell Safety and Health attorney with any questions about this development.