Short answer: no. None of the federal rules or accreditation standards we reviewed requires hospitals or behavioral health facilities to give staff panic buttons or duress badges. That covers OSHA's standards and guidance, CMS's hospital Conditions of Participation and its 2022 workplace violence memo, and the Joint Commission's workplace violence requirements.
What Joint Commission–accredited hospitals must have is a workplace violence prevention program. It includes an annual analysis of where staff are at risk, and action on what that analysis finds. Many states also require hospitals to have a workplace violence plan. A few name alarms in those rules, each in a different way.
Several vendor pages say otherwise. One error appears on more than one of them: calling Illinois Senate Bill 1435 a law. It is a bill that has not passed.
This guide quotes the relevant text of each source we reviewed, with links, as of October 17, 2026.
Does OSHA require panic buttons in hospitals?
No. OSHA has no workplace violence standard for health care.
OSHA's rulemaking on workplace violence in health care and social assistance sits in the federal regulatory agenda as a "Long-Term Action". Its proposed rule is listed as "To Be Determined" (RIN 1218-AD08).
You may see 29 CFR 1910.165 cited as a federal alarm requirement. Read its first line: "This section applies to all emergency employee alarms installed to meet a particular OSHA standard" (29 CFR 1910.165(a)(1)). It sets rules for alarms that another OSHA standard requires. It does not, on its own, require a hospital to install one.
OSHA's guidance for health care does recommend alarms. Its *Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers* (OSHA 3148) lists "panic buttons or paging system at workstations or personal alarm devices worn by employees" among engineering controls for hospitals. The same document says it is "advisory in nature" and "not a standard or regulation" (OSHA 3148).
So OSHA treats a worn alarm as a recommended control, not a legal requirement.
Does the Joint Commission require panic buttons or duress alarms?
No. The Joint Commission's workplace violence requirements for hospitals took effect January 1, 2022. None of them uses the words alarm, panic or duress (R3 Report, Issue 30).
What they do require:
- An annual worksite analysis. "The hospital conducts an annual worksite analysis related to its workplace violence prevention program. The hospital takes actions to mitigate or resolve the workplace violence safety and security risks based upon findings from the analysis."
- A program with a designated leader, policies to prevent and respond to violence, incident reporting, and follow-up for victims and witnesses.
- Training that covers "de-escalation, nonphysical intervention skills, physical intervention techniques, and response to emergency incidents".
The Joint Commission's current hospital manual groups these under NPG.02.04.01, "The hospital has a workplace violence prevention program." That section also names no device.
Joint Commission–accredited behavioral health care and human services organizations have had parallel workplace violence requirements since July 1, 2024 (R3 Report, Issue 42). They name no device either.
The suicide prevention goal for psychiatric hospitals and units is a separate requirement. It addresses ligature and environmental risks, not staff alarms.
The practical link is the worksite analysis. If yours finds places where staff cannot call for help quickly, the standard expects you to act on that finding. A worn duress alarm is one possible action. The standards do not name the measure, but the one you choose has to mitigate or resolve the risk you found.
What does CMS require?
CMS relies on a patient right, not an equipment rule. The hospital Conditions of Participation say "the patient has the right to receive care in a safe setting" (42 CFR 482.13(c)(2)).
CMS's 2022 memo on workplace violence in hospitals rests on that obligation (QSO-23-04-Hospitals). It does not prescribe alarms or devices.
Which state laws name alarms for hospitals and health care facilities?
Many states require hospitals to have a workplace violence prevention plan. Only a few mention alarms, and they do it in different ways. The list below covers the states we checked against the enacted text.
- California, 8 CCR 3342 (health facilities including acute psychiatric hospitals, home health and home-based hospice, EMS, drug treatment, outpatient care for incarcerated patients; not facilities run by the state corrections department): Corrective measure, "as applicable": "an alarm system or other effective means by which employees can summon security and other aid". Where layout prevents line of sight, "alarm systems or other effective means shall be provided". An alarm must not rely on an employee's voice
- New Jersey, N.J.A.C. 8:43E-11.8(b) (hospitals, psychiatric hospitals, nursing homes): Prevention measures include "the installation, as necessary, and maintenance of" items such as "alarm systems", "personal alarm devices" and "panic alarms"
- New York, Public Health Law § 2832 (Chapter 618 of 2025, A203-B, general hospitals; annual assessment and plan from January 1, 2027): The safety and security plan "shall specify methods to reduce identified risks, which may include" engineering controls "such as barriers, lighting, alarms and communication systems"
- Washington, RCW 49.19.020: The plan addresses "security systems, alarms, emergency response, and security personnel available"
- Minnesota, Minn. Stat. 144.566: Risk factors include "obstacles and impediments to accessing alarm systems" and "locations within the facility where alarm systems are not operational"
- Texas, SB 240 (2023), Health and Safety Code ch. 331: The plan must "address physical security and safety". No alarm wording
- Oregon, Connecticut, Maryland, Ohio, Virginia, Workplace violence plan, assessment, reporting or emergency department security laws: No alarm wording in the sections we read
Two readings matter here.
California lists "an alarm system or other effective means" among the corrective measures employers must take "as applicable". An alarm system is one way to meet it, not the only one.
New Jersey's list applies "as necessary". The facility's own risk assessment decides which of those items it needs.
None of these states requires a worn panic button for every hospital employee.
Is Illinois SB 1435 law?
No. Illinois Senate Bill 1435 would require every hospital employee to have "a panic button attached to their staff identification card." It was filed on January 31, 2025. Its last action, on March 27, 2026, re-referred it to the Senate Assignments Committee (ILGA bill status).
The bill's own text gives an effective date of July 1, 2025. That date has passed without the bill being enacted.
New York has a similar pending bill, S8724. It would require "wearable employee panic buttons or alert devices." Its status is "In Senate Committee", Health.
If a vendor tells you a state "requires" hospital panic buttons, ask for the chapter or public act number. A bill number alone is not a law.
What about the "Virginia" and "Florida" hospital panic alarm laws?
The Virginia and Florida panic alarm laws we found are school laws.
Florida requires each public school, including charter schools, to implement a mobile panic alert system known as Alyssa's Alert. Virginia's 2026 law (HB 592, Chapter 45) permits school boards to give school employees wearable panic alarm systems. Neither applies to hospitals. Both are covered on our Florida Alyssa's Law and Virginia Alyssa's Law pages.
Virginia's hospital licensing law directs the state Board of Health to require every hospital with an emergency department to have a security plan, based on a security risk assessment, with an off-duty law-enforcement officer or trained security staff present as that assessment indicates (Va. Code 32.1-127). It does not mention alarms.
What does this mean for behavioral health facilities?
No state or federal rule we found requires duress buttons in behavioral health facilities specifically.
Which rules apply depends on your facility type and accreditation:
- Joint Commission–accredited behavioral health organizations have the program, worksite analysis and training requirements.
- California's rule covers health facilities that treat physical or mental illness with stays of 24 hours or more, which includes acute psychiatric hospitals, and drug treatment programs.
- New Jersey's regulation covers psychiatric hospitals as well as general hospitals and nursing homes.
- Washington's law covers behavioral health programs and evaluation and treatment facilities as well as hospitals (RCW 49.19.010).
- Minnesota's law covers hospitals.
Use those requirements to answer three questions for each unit:
- Can a staff member call for help without speaking, and reach the means to do it in the moment? California defines an alarm as a device that "does not rely upon an employee's vocalization".
- Where is there no line of sight? Check seclusion rooms, patient bathrooms, medication rooms and night-time corridors, for example.
- Where do your existing alarms not work? Minnesota names "locations within the facility where alarm systems are not operational" as a risk factor. Test every area rather than assuming coverage.
Record the answers in your worksite analysis. Record the action you take on each finding, including the ones where you choose a measure other than an alarm.
Where does a worn duress button fit?
A worn button speaks to the first question. Staff carry it, so they do not need to reach a wall unit or speak. Whether it closes the gaps in the third question depends on coverage, which you test area by area.
Positive Proof's panic button solution comes in two configurations.
In the facility configuration, each staff member wears a two-button badge. One button calls on-site help, the other is for emergencies. The badge confirms a press to the wearer with one blink and makes no sound. Small anchors plugged into wall outlets give each alert the location where the button was pressed, and every alert carries a timestamped delivery record.
For staff who work away from the building, such as home health clinicians, a phone-paired configuration carries the alert from a worn device through the employee's phone.
A button does not replace the program the standards require. It is one measure your analysis can point to. For the hospital setting as a whole, see our healthcare safety overview.
Frequently asked questions
Are wearable duress buttons required for hospital workers in the US?
No. None of the OSHA standards, CMS rules or Joint Commission requirements we reviewed requires them. California lists an alarm system or other effective means for staff to summon help among corrective measures, as applicable. New Jersey lists personal alarm devices among measures to install as necessary. Illinois SB 1435 would require them but has not passed.
Does the Joint Commission require panic buttons for healthcare staff?
No. The Joint Commission requires accredited hospitals to have a workplace violence prevention program, an annual worksite analysis, incident reporting and staff training, including response to emergency incidents. None of its workplace violence requirements names alarms, panic buttons or duress devices. Hospitals must choose measures that mitigate or resolve the risks their analysis finds.
Does OSHA require panic buttons in hospitals?
No. OSHA has no health care workplace violence standard, and its rulemaking is listed as a long-term action. 29 CFR 1910.165 does not by itself require an alarm. OSHA's advisory guidance, OSHA 3148, recommends personal alarm devices but states that it is not a standard or regulation.
Which states mention alarms in hospital workplace violence rules?
California lists an alarm system or other effective means for staff to summon help among corrective measures, as applicable. New Jersey lists alarm systems, personal alarm devices and panic alarms, as necessary. New York lists alarms and communication systems among the engineering controls a general hospital's safety and security plan may include. Washington and Minnesota name alarms among factors the plan addresses.
Find the gaps your worksite analysis should cover
Talk with our team about where your staff cannot call for help today, and what a worn duress alarm would change. Request a demo.
