Existing law provides for the licensure of various health facilities, including general acute care hospitals, acute psychiatric hospitals, and special hospitals, by the State Department of Public Health. Existing law requires the department to adopt regulations that establish minimum, specific, and numerical licensed nurse-to-patient ratios by licensed nurse classification and by hospital unit for all general acute care hospitals, acute psychiatric hospitals, and special hospitals. Existing law requires the regulations adopted by the department for acute psychiatric hospitals that are not operated by the State Department of State Hospitals to take into account the special needs of the patients served in the psychiatric units.
This bill would specify that the adoption of these regulations adopted for acute psychiatric hospitals not operated by the State Department of State Hospitals are deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, and general welfare.
Existing law requires these health facilities to report specified adverse events to the department and prescribes the department's response.
This bill would require, when the department receives a complaint alleging a violation of the regulations related to nurse-to-patient ratios that does not involve a threat of imminent danger of death or serious bodily harm, the department to commence and complete an inspection within a specified time period.
Existing law requires the department to assess an administrative penalty of $15,000 for the first violation and $30,000 for the second and each subsequent violation if the department determines that a specified health facility has violated nurse-to-patient ratios, as specified. Under existing law, an acute general hospital is not subject to this administrative penalty if the hospital demonstrates it has met specified requirements, including that any fluctuation in required staffing levels was unpredictable and uncontrollable, prompt efforts were made to maintain required staffing levels, and the hospital immediately used and subsequently exhausted the hospital's on-call list of nurses and the charge nurse. Existing law specifies that multiple violations found on the same inspection survey constitute a single violation for purposes of determining whether the violation was a first, 2nd, or subsequent violation.
This bill would require, as part of meeting the above requirements, that the hospital provide the department with documentation that it used and exhausted the on-call list, as defined. The bill would require the on-call list to be at least 10% of the registered nurse staff for the hospital, and require all nurses assigned to an on-call list to possess and maintain, in writing, verified competencies specific to the unit for which they are on call. The bill would require the department to treat violations on separate days as separate violations.

Statutes affected:
SB 596: 1280.3 HSC
02/20/25 - Introduced: 1280.3 HSC
03/27/25 - Amended Senate: 1276.4 HSC, 1276.4 HSC, 1279.2 HSC, 1279.2 HSC, 1280.3 HSC