Safety and Liability: Security Guards in a Healthcare Setting

Health care providers consider it their mission to provide the highest level of health care services and patient safety within their communities. Over the past few years, violence has forced facilities to weigh the benefits of security enhancements as an expansion of their mission.

Facilities are now making decisions about the necessity of armed security guards on-site and their level of training. Many facilities have already utilized contracts with local law enforcement agencies to provide security details. While this is a great solution, contracts with local law enforcement should be written with care and thought. Law enforcement officers operate under very different policies and procedures on the streets that do not necessarily apply to a healthcare facility environment.

Consider the following incident scenarios:

A facility has contracted with a local police agency to have officers perform daily details. A 38- year-old female patient visits the emergency department for possible psychiatric evaluation accompanied by a family member. Before she can be triaged, the patient locks herself into one of the public restrooms. Facility management and security are contacted and bring the police officer on detail to the scene. The door is opened and the law enforcement officer forcibly removes the patient from the bathroom. The officer essentially carries the patient to an exam room and places her on a gurney with arguably such force that her arms were broken bilaterally. Who is responsible: the officer or the facility?

A visitor is engaged in a heated disruptive dispute with family members in a facility waiting room. The law enforcement officer on detail engages and disburses the involved parties. When the officer escorts the individual who was asked to leave the premises to the elevators, words are exchanged between them. The officer then tazes the individual. The family who had just moments earlier insisted on this relative’s removal immediately rallies to his defense. Who is responsible for this individuals’ alleged injuries: the officer or the facility?

Unfortunately for the healthcare organizations in both scenarios, the contract between facility and law enforcement agency did not contain any discussion about indemnification and defense, insurance requirements, training and educational requirements or the scope of the officer’s authority on levels of engagement.

Hiring outside security officers or guards through local law enforcement or a security company requires the same considerations. The contracts should be clearly written and specifically address the parties responsible for each type of duty, potential liability and defense exposures. Facilities should also assign responsibility to a designated party to perform background checks and ensure required training is completed. Local law enforcement agencies can be a resource to create helpful boundaries determining what guards can and cannot do within a facility.

Contracts with security companies and law enforcement agencies should be very specific to protect both the facility and the insurer from liability arising out of treatment and possible injury or death to patients, visitors and hospital staff members. The following items should be addressed in the contract:

• Liability Insurance/Workers’ Compensation – Liability and workers’ compensation insurance should be carried by the agency for the entire term of the contract. Legible certificates of insurance should be obtained from the insurance carrier or the agent. The certificates should be updated annually to make certain they are still in effect.
• Indemnity – An indemnity agreement should be in the contract stating the agency agrees to indemnify and hold the facility, its officers, and employees harmless from and against all liability for loss, damages, claims, causes of actions, costs or expenses (including attorney’s fees) arising out of or in any way connected with the negligent or intentional acts or omissions of the officers/guards (employees).
• Training – Contracts should require officers/guards of the agency to complete any and all training on facility policies and procedures, including de-escalation of violent situations.
• List of Duties – A specific list of duties should be stated to ensure clarity of exactly what is expected from the officers/guards on duty.
• Background Checks – These should be obtained, particularly when contracting a security service company.
• Use of Weapons/Force – This should be covered in the contract stating what type, if any weapons (guns, Tasers, pepper spray, batons, etc.) will be carried and/or used in the course of duty.