No single federal law requires every business or building to have an automated external defibrillator (AED). Instead, AED mandates come from a patchwork of state laws, federal aviation regulations, and local building codes, each targeting specific types of facilities. The requirements vary dramatically depending on where you are and what kind of organization you run.
There Is No Blanket Federal Mandate
OSHA, the federal agency responsible for workplace safety, does not require AEDs in any workplace. It encourages employers to install them, especially in settings where cardiac events are more likely, but there is no enforceable standard. The main federal role has been creating liability protections to encourage voluntary AED placement. Under 42 U.S.C. ยง 238q, anyone who uses an AED on a person in a perceived medical emergency is immune from civil liability, and so is the person or organization that purchased the device, as long as the device was properly maintained, local emergency responders were notified of its placement, and relevant employees received appropriate training.
The one clear federal mandate applies to commercial aviation. FAA regulations require at least one approved AED on every commercial aircraft operating under Part 121 (scheduled airlines). The device must be stored in the passenger cabin and maintained to the manufacturer’s specifications. This rule has been in effect since 2004.
Schools Are the Most Common Mandate
As of 2022, at least 20 states plus the District of Columbia require AEDs in schools. The specifics differ. Alabama mandates them in all public K-12 schools. Hawaii covers all public and private schools, including colleges and degree-granting institutions. New Jersey requires them in both public and private K-12 schools. Texas includes charter schools in its mandate.
Several states focus specifically on school athletics rather than the building itself. California requires AEDs in schools that offer sports programs. Louisiana mandates them at any institution of higher education that competes in intercollegiate athletics and at high schools with interscholastic athletics. Oklahoma similarly targets high school athletic events. Kentucky covers public and private schools along with their athletic events. These athletic-focused laws reflect the reality that sudden cardiac arrest in young people most often strikes during physical exertion.
Health Clubs and Fitness Centers
Gyms and fitness facilities are among the most commonly regulated settings for AEDs, which makes sense given the cardiac stress that comes with intense exercise. California requires AEDs in health studios, fitness centers, golf courses, and amusement parks. Illinois mandates them in fitness facilities. Oregon requires them in health clubs, along with schools and large commercial buildings (those over 50,000 square feet with at least 25 people congregating daily). New York, New Jersey, Maryland, and Rhode Island all include health clubs in their mandates as well.
Nursing Homes, Assisted Living, and Medical Offices
States with broader AED laws often include facilities that serve older or medically vulnerable populations. Connecticut requires AEDs in residential care homes, assisted living agencies, licensed dialysis facilities, and outpatient surgical facilities. New Jersey and Maryland include nursing homes and assisted living facilities. Rhode Island mandates them in nursing homes and assisted living facilities alongside public swimming pools and government buildings.
Dental offices are a less obvious but growing category. Kentucky, West Virginia, and Illinois all require AEDs in dental practices, particularly those that administer sedation or anesthesia, since these procedures carry a small but real cardiac risk.
Government Buildings and Public Spaces
Arizona requires AEDs in any state building constructed after 2002 or that has undergone major renovation since then. New York mandates them in state buildings, places of public assembly, and swimming facilities. Rhode Island has one of the broadest requirements in the country: every city, town, college campus, and judicial office in the state must have one. Connecticut and Maryland require them in courthouses and other public buildings.
Some states tie their requirements to building codes rather than standalone statutes. California’s building code, for example, requires AEDs in newly constructed or significantly renovated buildings based on occupancy type and capacity. Assembly spaces (auditoriums, theaters, event venues) trigger the requirement at 300 occupants, while educational, institutional, and residential buildings hit the threshold at 200 occupants. Health and fitness centers are required to have them regardless of size.
States With the Broadest Requirements
A handful of states stand out for the sheer range of facilities they cover. Rhode Island mandates AEDs in health clubs, nursing homes, assisted living facilities, public swimming pools, every municipal building, every college campus, and every judicial office. Connecticut covers schools, public buildings, higher education athletic departments, dialysis facilities, outpatient surgical centers, and assisted living agencies. Maryland spans swimming pools, physical therapy offices, courthouses, health clubs, schools, athletic events, nursing homes, and assisted living facilities.
At the other end of the spectrum, some states have no AED mandates at all or only cover a single setting like schools. Because these laws change frequently, checking your specific state’s current requirements is essential if you’re trying to determine whether your facility needs one.
What Compliance Looks Like
Simply buying an AED and mounting it on a wall is not enough to meet most state requirements. Laws typically require that you register the device with your local emergency medical services system so dispatchers know it exists. You need to keep the device maintained according to the manufacturer’s instructions, which means tracking battery and electrode pad expiration dates and replacing them before they expire.
Most state laws also expect that designated staff members receive training in how to use the device. Under the federal liability statute, an organization loses its legal protection if it fails to train employees who would reasonably be expected to use the AED. That said, modern AEDs are designed to walk an untrained person through every step with voice prompts, and many Good Samaritan laws protect bystanders who use one without formal training.
A practical maintenance routine involves checking the device’s status indicator weekly (most AEDs have a green light that confirms readiness) and doing a more thorough monthly check of supplies: pads, battery, gloves, scissors, and pocket mask. Any changes in the device’s location or status should be reported to your AED registry within 30 days.
Why Requirements Keep Expanding
About 350,000 cardiac arrests happen outside hospitals in the United States each year. For every minute that passes without defibrillation, the chance of survival drops roughly 7 to 10 percent. An AED applied within the first few minutes can raise survival rates dramatically, which is why legislators keep adding new facility types to their mandates. Even where AEDs are not legally required, placing one in any high-traffic location where people exercise, gather in large numbers, or receive medical care is increasingly treated as a basic standard of care. Organizations that choose not to install one may face questions about negligence if a cardiac arrest occurs on their premises, even in states without explicit mandates.