Nurse-to-patient ratios.

(1) Existing law requires the State Department of Public Health to adopt regulations that establish minimum, specific, and numerical licensed nurse-to-patient ratios for all licensed general acute care hospitals, acute psychiatric hospitals, or special hospitals. Existing law generally authorizes the department or the Office of Statewide Health Planning and Development to permit program flexibility as to various prescribed standards relating to a health facility's physical plant or staffing as long as statutory requirements are met and the program flexibility has prior written approval. A person who violates specified licensing provisions related to these health facilities is guilty of a crime. This bill would additionally require any program flexibility granted by the department or the office to not compromise patient care. The bill would specifically authorize the department to grant a staffing ratio program flexibility request, relating to nurse-to-patient ratios, pursuant to a prescribed procedure that includes, among other things, a requirement that the department post a staffing ratio program flexibility request on the department's publicly accessible internet website and solicit public comment on the request. The bill would authorize the department to revoke its approval of a staffing ratio program flexibility request for any reason and authorize an individual to request the department to review and consider revocation of an approved staffing ratio program flexibility request. (2) Existing law requires the department to assess a monetary administrative penalty on a licensed general acute care hospital, acute psychiatric hospital, or special hospital for a violation of the nurse-to-patient ratios established by the department, except as specified. This bill would additionally require the department to require one of these licensed health facilities that violated the nurse-to-patient ratios to post a notice relating to the violation. The bill would require the notice to include specific information, including a description, written in plain terms, of the date and nature of the violation, and further require the notice to be posted in certain locations inside the health facility for up to one year, as specified. By imposing these requirements on licensed health facilities, this bill would expand an existing crime, thereby imposing a state-mandated local program. (3) 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.