Violence is a daily occurrence at many healthcare facilities. The traditional flashpoint for violence has typically been the emergency department of an acute care hospital, however other facilities such as assisted care facilities and skilled nursing facilities encounter crime and violence on their campuses as well.

Due to the wide range of facilities that provide long term care service, numerous factors can influence the type of crimes most often encountered in these settings. Common violence encountered in the long-term care service industryis residents assaulting staffor each other.

Maintaining adequate security in these facilities can be challenging for a variety of reasons including campus design, residents who may suffer from dementia or other cognitive impairments, the potential for criminal activity due to patient valuables and residents’ inability to recall details.



Assisted Care- Sometimes referred to as assisted living, retirement homes, or personal care facilities, are suitable for individuals who need very little daily care. Residents may need medication assistance and some assistance with activities of daily living. Assisted care facilities allow individuals to remain independent as long as possible in an environment that maximizes the person’s autonomy, dignity, privacy, and safety, as well as emphasizes family and community involvement.1


nursing homes-Nursing homes, also called skilled nursing facilities, provide a wide range of health and personal care services. Their services focus on medical care more than assisted care facilities. These services typically include nursing care, 24-hour supervision, three meals a day, and assistance with activities of daily living. Rehabilitation services, such as physical, occupational, and speech therapy, are also available.2 Although it may differ with individual companies, security is frequently left in the hands of staff and administrators in these types of facilities.

Continuing Care Retirement Communities – Often referred to as a CCRC or life care communities, these offer different levels of service in one location. Many of them offer independent housing (houses or apartments), assisted living, and skilled nursing care all on one campus. Healthcare services and recreation programs are also provided. In a CCRC, where you live depends on the level of service you need. People who can no longer live independently move to the assisted living facility or sometimes receive home care in their independent living unit. If necessary, they can enter the CCRC’s nursing home.

Some of the largest CCRCs can be compared to a small town or community. These campuses can sprawl hundreds of acres with on-site amenities such as banking and postal facilities, golf courses, restaurants and bars as well as beauty salons and massage therapy studios. Many also have a full-time security department with uniformed security officers who provide a wide-variety of security services to residents and staff. Some officers may be trained as first responders with additional skills such as emergency medical technician training.

Rehabilitation Facilities – These are typically part of a skilled nursing facility. Common patients include those recovering from joint replacement surgery or those that have been hospitalized for a long period of time. Other commonly encountered patients are those suffering from the effects of a stroke and traumatic brain injuries. These types of patients can result in an increased risk of violence toward healthcare providers. Assaults on staff, and patients displaying aggressive behaviour are commonly reported incidents encountered by staff when interacting with these patients.4



Providing safety and security to residents of a skilled nursing or assisted care facility can be challenging yet rewarding. Personnel at these facilities provide protection for a vulnerable population who are dependent upon others for their safety and security. While crime and violence may occur in all types of health care facilities, assisted care and skilled nursing facilities are unique due to the many residents who may suffer not only from physical disabilities associated with aging, but also from differing degrees of cognitive impairment. It is imperative that facility administrators and those that are responsible for security, recognize the threats and vulnerabilities associated with these facilities and ensure proper prevention and mitigation steps are in place.

Source: IAHSS Foundation

Author: Dean Conner

24 Grigorovtsi Str 
Gabrovo, Bulgaria


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