“One Worksite, One Employer”: The Eleventh Circuit Defines Single-Employer Liability and the Secretary’s Burden of Proving Economic Feasibility under OSHA’s General Duty Clause

Introduction

UHS of Delaware, Inc. v. Secretary of Labor, No. 23-11327 (11th Cir. June 18, 2025) is a significant Occupational Safety and Health Act (OSH Act) decision that addresses two recurring issues in workplace-safety enforcement:

Single-employer status – whether a management company (UHS-DE) and the licensed facility it supervises (Suncoast Behavioral Health Center) can be treated as one employer for liability purposes.
The Secretary’s prima facie burden – specifically, the requirement that each proposed abatement measure be proven both effective and economically feasible before an employer can be ordered to implement it under the General Duty Clause, 29 U.S.C. § 654(a)(1).

The Eleventh Circuit largely affirmed an Occupational Safety and Health Review Commission (OSHRC) decision that sustained a General Duty Clause citation for failing to protect staff from patient-on-staff violence at a psychiatric hospital. However, the Court vacated the Commission’s findings with respect to two staffing-related abatement measures because the Secretary offered no evidence of their economic feasibility. The ruling simultaneously clarifies how integrated healthcare systems may be swept into liability and how employers can contest abatement terms that lack an evidentiary foundation.

Summary of the Judgment

The Court issued a split outcome:

Petition denied as to single-employer liability. The Court upheld the OSHRC’s conclusion that UHS-DE and Suncoast operated as a single employer because they shared a common worksite, interrelated safety operations, and common management.
Petition granted in part as to two disputed abatement measures. The Eleventh Circuit set aside the ALJ’s finding that round-the-clock, specially-trained security staffing was feasible. No cost evidence was introduced, so the finding was “arbitrary and capricious.”
Citation sustained. Six other abatement measures were undisputed; thus, at least one feasible and effective method remained, satisfying the Secretary’s burden and leaving the General Duty Clause citation in place.

Analysis

1. Precedents Cited

Sec’y v. Southern Scrap Materials Co., 23 OSHC 1596 (2011) – Provides the three-factor test (common worksite; interrelated operations, especially regarding safety; common management/ownership) to determine single-employer status.
Loretto-Oswego Residential Health Care Facility, 692 F.3d 65 (2d Cir. 2012) – Distinguished by the Court; management company there exercised limited control over safety matters, unlike UHS-DE here.
Georgia Electric Co. v. Marshall, 595 F.2d 309 (5th Cir. 1979) – Quoted for the four elements of a General Duty Clause violation.
Beverly Enterprises, Inc., 19 OSHC 1161 (2000) – Cited for the Secretary’s obligation to prove technological and economic feasibility of abatement.
UHS of Westwood Pembroke, Inc., 2022 OSHC (BNA) – Adopted by the Court for the proposition that the Secretary need prove only one feasible and effective abatement method when alternatives are proposed.

By aligning itself with Westwood Pembroke—a companion case out of the Third Circuit—the Eleventh Circuit strengthened what now appears to be a developing national standard for General Duty Clause abatement proofs.

2. Legal Reasoning

a. Single-Employer Analysis

Common Worksite: Key executives employed by UHS-DE (CEO, CFO, COO-trainee, Director of Nursing) maintained offices inside the Suncoast hospital and made rounds on patient units, exposing them to the same hazard.
Interrelated Safety Operations: UHS-DE drafted the Workplace Violence Policy, training modules, code of conduct, risk-management forms, and chaired the Patient Safety Council and Environment of Care Committee. Minimal, if any, site-specific alterations were permitted without UHS-DE approval.
Common Management / Ownership: Both entities were subsidiaries within the UHS corporate family; day-to-day operational control of Suncoast rested with UHS-DE personnel.

Because all three factors were met, the Court affirmed that UHS-DE and Suncoast constitute a single employer. By extension, integrated health systems—and corporations with embedded management teams—are on notice that corporate form alone will not shield a parent or management affiliate from OSHA liability.

b. Proof of Feasible Abatement

Secretary’s Burden: The Court reiterated that the Secretary must establish that a proposed abatement measure is both effective and economically feasible.
Failure of Proof: Expert Dr. Lipscomb admitted she “did not” assess cost. Dr. Forman never addressed costs. Without any economic evidence, the ALJ’s acceptance of Measures 3 and 4 (specialized security staff 24/7) was unsupported.
Harmless Error? Although the two measures were vacated, six unchallenged measures stood. Citing Westwood Pembroke, the Court held that one proven feasible measure is sufficient for liability; therefore, the citation survived.

c. Regulatory-Type Requirements Argument

The petitioners argued that OSHA was effectively promulgating security staffing regulations via litigation. The Court rejected that narrative because OSHA did not mandate adoption of any particular measure; it merely identified acceptable options. Employers remain free to design alternative controls so long as they render the workplace free of the hazard.

3. Impact of the Decision

Healthcare Sector Vigilance. Psychiatric, emergency, and long-term-care facilities commonly face patient aggression. The decision confirms that corporate parents or management service organizations that embed executives in a facility can be directly cited.
Strengthened “Single Employer” Doctrine. By approving a robust application of the Southern Scrap factors, the Eleventh Circuit joins the First and Third Circuits in treating integrated employers as one entity, even absent formal co-employment contracts.
Economic Feasibility Evidence Required. Going forward, the Secretary must come prepared with cost analyses, budget comparisons, or industry surveys to sustain abatement provisions that impose appreciable expense—particularly staffing mandates.
Limited Remand Relief. Vacating one defective measure does not undermine a General Duty citation if other feasible methods remain. Employers contesting citations should attack all abatement alternatives or risk a hollow victory.
OSHA Enforcement Strategy. The decision subtly encourages OSHA to draft citations with multiple, alternative abatement measures, knowing that the survival of one will suffice.

Complex Concepts Simplified

General Duty Clause (GDC): A catch-all safety obligation used when no specific OSHA standard governs the hazard. The Secretary must prove four elements, including the availability of a feasible, effective abatement method.
Feasible vs. Effective: “Feasible” means the employer can reasonably implement the measure with existing technology and without crippling economic impact; “effective” means the measure will actually reduce the hazard.
Single-Employer Doctrine: OSHA may pierce corporate separateness where affiliated entities share a worksite, integrate operations (especially safety), and have common management. Liability and citation penalties apply to the unified enterprise.
Abatement Measure: A method proposed by OSHA to eliminate or mitigate a hazard—e.g., engineering controls, staffing adjustments, procedural changes, or personal protective equipment.

Conclusion

UHS of Delaware, Inc. v. Secretary of Labor crystallizes two important OSHA enforcement principles:

Integrated control equals integrated liability. Where a parent or management company embeds executives and tightly controls safety policy, OSHA and the courts will treat the entities as a single employer.
The Secretary must prove the dollars and cents. Abatement measures—especially those that impose recurring labor costs—require an evidentiary showing of economic feasibility; otherwise they will be vacated.

For employers, the case underscores the need to:

Document cost analyses and seek cost-effective alternatives during abatement negotiations.
Clearly delineate safety responsibilities in management agreements if separate corporate entities are involved.
Proactively implement and evaluate violence-prevention programs, thereby reducing both hazards and litigation risk.

For OSHA, the lesson is twofold: assemble sufficient economic evidence when proposing costly remedies, and continue framing citations with multiple abatement options to withstand partial judicial setbacks. The Eleventh Circuit’s decision therefore advances employee protection while refining due-process limits on OSHA’s enforcement powers—a precedent likely to influence healthcare and other high-hazard industries nationwide.