Increasing Immigration Enforcement in the Hospital Setting: Public Health Risks and Guidance for Hospitals and...

Healthcare settings, dedicated to patient care and healing, have traditionally been somewhat insulated from broader political and cultural controversies. However, on January 21, 2025, the Department of Homeland Security rescinded the "sensitive location" designation for hospitals and other healthcare facilities, permitting Immigration and Customs Enforcement to conduct more enforcement actions in these settings. The previous sensitive location designation effectively meant that immigration enforcement actions, such as arrests or surveillance, were to be avoided absent exigent circumstances (i.e., emergent situations in which inaction would compromise safety or law enforcement goals). As a result, healthcare professionals are likely to encounter increased immigration enforcement activity in the workplace, raising important concerns about patient privacy, public health, and the professional responsibilities of clinicians and health systems. In this viewpoint, we offer practical guidance for healthcare professionals and institutions on mitigating risks to patient privacy and safety amid heightened immigration enforcement in healthcare settings, and we explain the narrow circumstances under which immigration officials may lawfully request or obtain identifying patient information. Our aim is to offer suggestions to help foster a patient care environment that maximizes patient trust and safety. We also hope to assist in clarifying healthcare systems' legal obligations.