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Region 4

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July 01, 2015

Judge affirms OSHA findings in 2012 death of health care coordinator
killed by mentally ill client with violent criminal history
Integra Health Management failed to protect employee from workplace violence hazards

TAMPA, Fla. - After the horrific murder of a Florida health care worker in 2012, an administrative law judge affirmed in June that her employer failed to protect her from workplace violence.

Judge Dennis Phillips of the Occupational Safety and Health Review Commission determined Integra Health Management - now operating as Integra ServiceConnect LLC - did not protect Stephanie Ross, a 24-year-old social service coordinator. Her client, with severe mental illness and a violent criminal history, fatally stabbed Ross outside his home in December 2012. On-the-job for approximately three months, Ross had prior meetings with the man and recorded in her case notes that she was uncomfortable being alone with him.

Like other social service coordinators, Ross visited dangerous and violent clients in their homes and coordinated case management. To perform mental and physical health assessments, she transported clients in her vehicle.

"The safety of social service workers in the field is a serious concern. Many face threats and violence in the workplace. Integra put its workers at risk of injury or worse by choosing not to implement commonly recognized safety practices and protocols," said Leslie Grove, OSHA's director of the Tampa Area Office. "Employers must take every reasonable precaution to protect employees against safety and health hazards in the workplace, including physical assaults."

OSHA investigators found Integra knew the assailant had exhibited several high-risk behaviors - including a history of violence, criminal behavior, schizophrenia and paranoia - but took no steps to protect its employee. The agency also discovered multiple incidents where Integra employees were victims of aggression and verbal and physical threats from clients. OSHA concluded that the company did not conduct a hazard assessment of the service coordinator position or develop a written program to prevent workplace violence hazards.

Investigators issued two serious citations with full penalties to Integra in March 2013 for failing to protect employees from violence in the workplace and not reporting Ross' death to OSHA. The company contested the citations that went before the commission for review. Judge Phillips found that Integra's approach to safety was inadequate, and the company should have taken precautions to prevent injury by hiring and training its employees appropriately. The citations bring penalties of $10,500.

In future health care industry inspections, the U.S. Department of Labor's Occupational Safety and Health Administration announced recently that it would expand its enforcement resources to focus on workplace violence and other safety and health risks.

Based in Owings Mills, Maryland, Integra Health Management is a health care service company specializing in community-based nonclinical support for individuals with health care and related social service needs. Integra contracts with insurance companies to perform mental and physical health assessments and coordinates case management for high-risk, high-cost members. It operates in Tennessee, Pennsylvania, Maryland and Florida.

On June 25, OSHA announced that it added musculoskeletal disorders, bloodborne pathogens, workplace violence, tuberculosis and slips, trips and falls as key hazards for investigators to focus on in health care inspections. The action targets some of the most common causes of workplace injury and illness in the health care industry.

Bureau of Labor Statistics data from the preliminary Census of Fatal Occupational Injuries shows fatal work injuries in Florida accounted for 218 of the 4,405 fatal work injuries reported nationally in 2013. Additional details are available at

To ask questions, obtain compliance assistance, file a complaint, or report amputations, eye loss, workplace hospitalizations, fatalities or situations posing imminent danger to workers, the public should call OSHA's toll-free hotline at 800-321-OSHA (6742) or the agency's Tampa Area Office at 813-626-1177.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA's role is to ensure these conditions for America's working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit


Media Contacts:

Lindsay Williams, 678-237-0630,
Michael D'Aquino, 678-237-0630, d'

Release Number: 15-1282-ATL (200)

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