The Health and Safety Code requires the California Department of Public Health (Department) to establish and enforce regulations on minimum nurse-to-patient staffing ratios in health facilities across the state. The Department possesses the authority to assess administrative fines against any facility that fails to staff nurses at levels sufficient to satisfy applicable ratios, with increasing penalties for subsequent violations. Under the Health and Safety Code, the health facilities subject to these rules include “acute general hospitals,” which the Health and Safety Code generally defines as hospitals with an organized medical staff that provides 24-hour inpatient care and offers basic services, such as medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy, and dietary care.
The Health and Safety Code exempts an acute general hospital from administrative penalties for violating nurse-to-patient staffing ratio regulations if the hospital can show that fluctuations in staffing levels were unpredictable and uncontrollable, that it made prompt efforts to maintain the requisite nurse-to-patient staffing ratio, and that it immediately used and exhausted its list of on-call nurses and the charge nurse. Currently, multiple violations found during the same inspection survey count as a single violation when determining whether it is a first, second, or subsequent offense.
SB 596 defines “on-call list” for these staffing requirements as a list of nurses scheduled to be on-call for the specific shift and unit where a violation occurred, or nurses assigned to a regularly scheduled float pool shift to cover shortages in one or more designated units. SB 596 clarifies that, if a hospital contacts or attempts to contact licensed nurses who are not scheduled to be on-call or assigned to a float pool for that unit and shift, the Department will not consider the hospital to have used and exhausted its on-call list.
While SB 596 does not change the rule that multiple violations found during the same inspection survey count as a single violation, SB 596 clarifies that violations discovered on different days count as separate violations.
(SB 596 amends Section 1280.3 of the Health and Safety Code.)