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ACKNOWLEDGEMENTS

We extend our sincere appreciation to the healthcare security professionals who operate daily in demanding, high-pressure environments. Their commitment to safety and resilience has been especially evident through the challenges of recent years. We also thank the facilities that completed the Healthcare Crime Survey; your participation strengthens the field, provides meaningful benchmarks, and supports shared learning across the healthcare security community. Finally, we acknowledge the IAHSS staff for their continued dedication to supporting both this survey and the broader mission of advancing healthcare security and safety

INTRODUCTION

The International Association for Healthcare Security and Safety (IAHSS) Foundation was established to promote the welfare of the public through education, research, and the development of a comprehensive body of knowledge for healthcare security and safety. The Foundation supports research initiatives focused on improving healthcare security practices and provides scholarships to advance professional development within the field. Additional information about the IAHSS Foundation is available at www.iahssf.org.

The 2025 Healthcare Crime Survey was commissioned through the IAHSS Foundation’s Research and Grants Program. The purpose of the survey is to provide healthcare security professionals with a data-driven understanding of the frequency, nature, and trends of crime and workplace violence (WPV) occurring in healthcare facilities across the United States. Healthcare security leaders were invited to participate, and when respondents were responsible for more than one facility, a separate survey was requested for each location.

Consistent with prior Crime Surveys, the 2025 edition collected data on ten primary crime categories:

  • Murder
  • Rape
  • Robbery
  • Aggravated Assault
  • Simple Assault
  • Burglary
  • Theft
  • Motor Vehicle Theft
  • Vandalism
  • Disorderly Conduct

To promote consistency and comparability, the survey incorporated the Federal Bureau of Investigation’s Uniform Crime Reporting (UCR) definitions. These definitions were embedded directly within the survey instrument and are included in the Appendix for reference.

Rates were calculated primarily per 100 licensed beds using the formula (Incidents ÷ Beds) × 100. In select analyses, rates were also normalized per 100 security full-time equivalent (FTE) personnel to account for staffing variation across facilities. In cases where extreme values materially influenced results, adjusted rates excluding significant outliers were used and clearly identified.

2024 Data Overall Analysis

The 2024 IAHSS Foundation Healthcare Crime Survey reflects a high degree of continuity with prior survey years. Type 2 WPV—violence directed at staff by patients or visitors—remains the dominant driver of assaults and disruptive incidents across healthcare facilities. Facilities operating inpatient psychiatric or behavioral health (BH) units continue to experience significantly higher volumes of behavioral incidents, while simultaneously maintaining lower patient elopement rates. This pattern reinforces the long-standing protective effects associated with specialized behavioral health infrastructure and staffing models.

Facilities with Threat Management Teams (TMTs) and Visitor Management Systems (VMS) again reported higher overall incident rates. As in previous years, these elevated rates reflect facility size, behavioral acuity, public interface complexity, and more mature reporting practices rather than increased inherent violence. Larger and more complex facilities consistently demonstrate greater risk visibility and documentation fidelity.

While overall patterns remained stable in 2024, several notable shifts emerged. Adoption of TMTs and VMS declined modestly compared to 2023, and facilities without BH units experienced rising behavioral incident rates when adjusted metrics were examined. These trends suggest increasing operational strain in non-specialty environments, particularly where behaviorally complex patients are managed outside of dedicated behavioral health settings.