Health Care Coalition Seeks Federal Guidance on ER Violence Prevention Signage

Groups call for clarity on posting signs to address escalating workplace violence in emergency rooms.

Jan. 28, 2026 at 3:15pm

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A coalition of 10 major health care organizations, including the American College of Emergency Physicians and the American Hospital Association, has written to the Centers for Medicare and Medicaid Services (CMS) requesting clear federal guidance on posting signage in emergency rooms to discourage violence against staff. The groups claim violence in ERs has 'escalated significantly in recent years' and is contributing to a shortage of frontline health care workers.

Why it matters

Workplace violence against health care workers, especially in emergency rooms, has become an increasingly serious issue in recent years. The coalition argues that clear signage is necessary to set expectations for respectful behavior and emphasize that violence will not be tolerated. However, they say CMS has provided limited guidance on what type of signage would be allowed without violating other regulations, creating uncertainty for hospitals.

The details

In a January 20 letter to CMS Administrator Mehmet Oz, the coalition requested written guidance to facilitate the posting of signs discouraging violence in emergency rooms. The groups say some hospital surveyors have questioned or cited 'neutral' workplace violence signs as potential violations of the Emergency Medical Treatment and Labor Act (EMTALA), 'essentially forcing hospitals who want to protect vulnerable frontline staff to take a leap of faith in posting signage that is their 'best guess' as compliant'.

  • The coalition sent the letter to CMS on January 20, 2026.

The players

American College of Emergency Physicians

A national medical specialty society representing emergency medicine physicians and related health care providers.

Centers for Medicare and Medicaid Services

The federal agency that administers the Medicare program and works in partnership with state governments to administer Medicaid.

Mehmet Oz

The current Administrator of the Centers for Medicare and Medicaid Services.

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What’s next

The coalition is asking CMS to provide written guidance on acceptable workplace violence signage, communicate any clarifications directly to state survey agencies and accrediting organizations, and incorporate the guidance into surveyor training materials and FAQs.

The takeaway

This request highlights the growing crisis of workplace violence in health care settings, especially emergency rooms, and the need for clear federal policies to support hospitals in protecting their frontline staff. Addressing this issue is critical to maintaining a robust health care workforce and ensuring patient safety.