The Tenth Circuit Court of Appeals is examining a dispute over workplace safety penalties imposed on UHS of Delaware, Inc. and Cedar Springs Hospital, Inc., in a case that could clarify the liability of management companies for safety violations at healthcare facilities they operate.
UHS of Delaware filed a petition for review on Feb. 13, challenging an order from the Occupational Safety and Health Review Commission that imposed administrative penalties on both the hospital owner and management company. The case, *UHS of Delaware, Inc. v. Occupational Safety and Safety Review Commission* (10th Cir. 2026), involves the complex relationship between Cedar Springs Hospital, Inc., which owns the psychiatric facility, and UHS of Delaware, Inc., which serves as the management company.
According to court documents, the dispute arose after federal safety inspectors found inadequate safety measures at the psychiatric hospital. The Occupational Safety and Health Administration brought enforcement action under 29 U.S.C. § 654(a)(1), the general duty clause of the Occupational Safety and Health Act, which requires employers to provide a workplace free from recognized hazards.
The central legal question before the three-judge panel is "whether the relationship subjected the management company to the penalties." Circuit Judge Neil Bacharach, writing for the court, noted that the case concerns the relationship between the hospital owner and management company, and how that relationship affects liability for safety violations.
The case highlights the increasingly complex corporate structures in healthcare, where facilities are often owned by one entity but managed by another. UHS of Delaware operates as the management company for Cedar Springs Hospital, creating a web of responsibilities that federal safety regulators must navigate when violations occur.
UHS of Delaware is represented by Kip Adams and Patricia B. Gary from Lewis, Brisbois, Bisgaard & Smith LLP in Boston. The legal team is challenging the Review Commission's determination that the management company should face penalties alongside the facility owner.
The federal government's position is being defended by the Department of Labor's Office of the Solicitor, with Leigh Anne Schriever serving as the lead attorney. The government's legal team includes Solicitor of Labor Seema Nanda, Associate Solicitor Edmund C. Baird, and appellate counsel Louise McGauley Betts.
The case reflects broader tensions in workplace safety enforcement, particularly in healthcare settings where patient care and worker safety intersect. Psychiatric hospitals face unique safety challenges, including risks from patient violence, medication handling, and specialized equipment that requires careful safety protocols.
OSHA's general duty clause, codified at 29 U.S.C. § 654(a)(1), requires employers to furnish employees with a workplace "free from recognized hazards that are causing or are likely to cause death or serious physical harm." The provision serves as a catch-all for safety violations that may not be covered by specific OSHA standards.
The Occupational Safety and Health Review Commission, an independent federal agency, adjudicates disputes between OSHA and employers over citations, penalties, and abatement requirements. When employers disagree with the commission's decisions, they can petition federal circuit courts for review, as UHS of Delaware has done in this case.
For management companies in the healthcare sector, the outcome could establish important precedent about when they can be held directly liable for safety violations at facilities they operate but do not own. The decision may influence how OSHA targets enforcement actions in cases involving complex corporate relationships.
The Tenth Circuit's jurisdiction covers Colorado, Kansas, New Mexico, Oklahoma, Utah, and Wyoming, along with parts of Montana and North Dakota. Healthcare management companies operating across this region will be watching closely for guidance on their potential liability exposure.
Circuit Judges Chief Judge Timothy Tymkovich and Judge Allison Eid Phillips are joining Judge Bacharach on the three-judge panel hearing the case. The court has not yet scheduled oral arguments or indicated when a decision might be issued.
The case underscores the federal government's continued focus on healthcare workplace safety, particularly in psychiatric settings where workers face elevated risks. Recent years have seen increased OSHA enforcement in healthcare facilities, with particular attention to violence prevention programs and safe patient handling procedures.
As healthcare consolidation continues and management arrangements become more complex, the legal framework for assigning safety responsibilities becomes increasingly important. The Tenth Circuit's decision will provide clarity for similar arrangements across the healthcare industry and may influence how federal safety regulators approach enforcement in cases involving multiple corporate entities.
The court's ruling will determine whether UHS of Delaware must pay the administrative penalties or whether the Review Commission exceeded its authority in holding the management company liable for safety violations at the psychiatric facility it manages but does not own.