ALBANY — As the head of an organization representing 50 upstate hospitals, Gary Fitzgerald says health care executives frequently express their concerns to them about the hostile and confrontational treatment their medical staffers face on the job.

“Almost every C.E.O. we’ve talked to over the last year and a half and have said the patient population and family members have become increasingly more violent and dangerous,” Fitzgerald, president of the Iroquois Healthcare Alliance, told CNHI.

Tensions in hospitals have been fueled by shortages of medical professionals, most notably nurses, which has led to longer wait times for patients seeking treatment at emergency rooms and other clinics within health care facilities, Fitzgerald said.

Fitzgerald”s experiences in working with New York hospitals mirror the concerns outlined this week in a detailed memo published by the federal Centers for Medicaid and Medicare Services.

The agency said it is urging the leaders of healthcare facilities — hospitals, nursing homes and clinics — to “ensure they provide adequate training, sufficient staffing levels, and ongoing assessment of patients and residents for aggressive behavior and indicators to adapt their care interventions and environment appropriately.”

Citing data assembled by the U.S. Bureau of Labor Statistics, CMS officials said violence against health care workers has been rising steadily since 2011.

In 2018, health care workers accounted for 73% of all workplace non-fatal injuries and illnesses stemming from acts of violence, the officials noted. Beyond their workforce, hospitals also have a duty to provide care to patients in a safe setting, the CMS said.

“The hospital must protect vulnerable patients, including newborns and children,” the CMS memo stated. “Additionally, this standard is intended to provide protection for the patient’s emotional health and safety as well as his/her physical safety. Respect, dignity and comfort would also be components of an emotionally safe environment.”

National organizations representing healthcare professionals are also decrying what they call a surge in violence directed at hospital staffers. One of the incidents that focused national attention on the uptick in violence against health workers was the killing of two doctors, a receptionist and a visitor at a medical building in Tulsa, Oklahoma last June.

Authorities said the primary target was an orthopedic doctor who had performed back surgery on the gunman just weeks before the killings. The president and CEO of the Association of American Medical Colleges, Dr. David Skorton, and the president of the National Academy of Medicine. Dr. Victor Dzau, condemned the violence in a joint statement.

They also urged Congress to pass the bipartisan Safety from Violence for Healthcare Employees (SAVE) Act.

The measure would provide protections against threats and violence aimed at health care workers. There would also be funding for hospital programs aimed at making the facilities more secure.

At Bassett Healthcare Network, serving residents of eight counties and headquartered in Cooperstown, spokeswoman Gabrielle Argo said providing a safe environment for workers and patients is a top priority for administrators.

The staffing challenges faced by the healthcare industry, as well as the lingering emotional toll taken on people who had limited contact with others during the pandemic, has elevated the need to address the potential for violence at medical facilities, Argo said.

“It’s been a perfect storm for pent-up frustration to emerge in ways we haven’t seen before,” she said.

In a move aimed at helping Bassett’s security teams de-escalate workplace incidents rapidly, all Bassett employees were equipped last year with Bluetooth-based personal alert buttons designed to be used when an emergency arises.

“We all have one, and we are the first health system in the nation to roll it out to every single location across our eight-county area,” Argo said.

In Plattsburgh, at the Champlain Valley Physicians Hospital, communications specialist Chris Blake said the hospital had no immediate comment on the advisory from the Centers for Medicaid and Medicare Services. Federal officials said all hospitals are expected to implement a patient risk assessment strategy, noting those strategies should be “appropriate” for the type of care being provided.

“For example, a patient risk assessment strategy in a post-partum unit would most likely not be the same risk assessment strategy utilized in the emergency department,” the federal memo stated.