General acute care hospitals: nurse-to-patient ratios.

Existing law establishes the State Department of Public Health and sets forth its powers and duties, including, but not limited to, the licensing and regulation of health facilities, as defined. Existing law requires the department to adopt regulations governing the operation of a health facility, including, but not limited to, regulations that require prescribed health facilities to meet minimum nurse-to-patient ratios, and to assign additional staff according to a documented patient classification system for determining nursing care requirements. Violation of these provisions, or willful or repeated violation of the rules or regulations, is a crime. This bill would, with respect to this patient classification system, require that a committee for each general acute care hospital review the reliability of this system for validating staffing requirements at least annually to determine whether the system accurately measures patient care needs. The bill would require that at least 50% of the committee members be registered nurses who provide direct patient care. The bill would require that these nurses be appointed by the bargaining agent of the registered nurses, if any, and in the absence of a bargaining agent, by the nursing administrator. The bill would require the remaining members of the committee to be appointed by the nursing administrator. By changing the definition of an existing crime, this bill would impose a state-mandated local program. This bill would state that it is the Legislature's intent in enacting these provisions to supersede specified provisions of a certain regulation, and not to affect any other law. Existing law requires the department to periodically inspect every licensed health facility for compliance with state law and regulations. This bill would require the department, during its periodic inspection of a general acute care hospital, to inspect for compliance with the minimum nurse-to-patient ratios established pursuant to existing law. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.