Health facilities: administrative penalties.

The entire amendment to Health and Safety Code Section 1276.4 was removed. This section had addressed nurse-to-patient ratio regulations, including language deeming adoption of psychiatric hospital staffing regulations an emergency necessary for public safety. The bill now only amends Sections 1279.2 and 1280.3.

The definition of 'on-call list' in Section 1280.3(f)(4)(A)(iii) was narrowed. The old version defined it as a documented list of nurses scheduled to be on call outside their regularly scheduled shifts, with float pool nurses able to count toward it. The new version defines it as nurses scheduled to be on call for the specific shift and unit where the alleged violation occurred, or nurses assigned to a regularly scheduled float pool shift covering specified units.

Removed the requirement that hospitals provide the department with documentation proving they used and exhausted their on-call list when claiming the penalty exemption for nurse-to-patient ratio violations.

Removed the requirement that a hospital's on-call list be at least 10 percent of its registered nurse staff to qualify for the penalty exemption.

Removed the requirement that all nurses assigned to an on-call list possess and maintain, in writing, verified competencies specific to the unit for which they are on call.

The entire amendment to Health and Safety Code Section 1279.2 was removed. This section had established specific inspection timeframes: the department would have been required to commence an inspection within 10 business days and complete it within 60 days upon receiving a complaint alleging a nurse-to-patient ratio violation that does not involve imminent danger of death or serious bodily harm.

The bill title was narrowed from 'An act to amend Sections 1279.2 and Section 1280.3' to 'An act to amend Section 1280.3,' reflecting the removal of the inspection timeframe provisions.

Header changed from enrolled bill format (Senate/Assembly passage dates) to chaptered format with Chapter 773 designation and Governor approval date of October 13, 2025.

Page numbers changed from 94 to 93 to reflect the Statutes at Large pagination.

Signature block updated from a blank approval line to the Governor's signature mark.

The definition of 'on-call list' was expanded to specify that it must be comprised of nurses scheduled to be on call for the specific shift and unit where an alleged violation occurred, or nurses assigned to a regularly scheduled float pool shift covering one or more specified units.

A new sentence was added stating that a hospital contacting or attempting to contact licensed nurses who are not scheduled to be on call and who are not assigned to a float pool for the unit and shift where an alleged violation occurred shall not be considered as exhausting an on-call list. This closes a potential loophole where hospitals could claim they 'exhausted' their on-call list by calling any available nurse.

Section numbering within the bill was reorganized (SEC. 2 and SEC. 3 now contain internal section references), and page numbers were updated from 97 to 96, reflecting a re-pagination of the document.

The bill now amends Sections 1276.4 and 1279.2 in addition to Section 1280.3, expanding from a penalty-focused bill to one that also addresses how ratio regulations are adopted and how complaints about staffing violations must be investigated.

New Section 1276.4(k) deems the adoption of nurse-to-patient ratio regulations for acute psychiatric hospitals not operated by the State Department of State Hospitals to be an emergency, allowing them to take effect on a shortened timeline without waiting for the standard regulatory process.

New Section 1279.2 establishes mandatory timeframes for department investigations: 48 hours/two business days to begin and 45 days to complete for imminent danger situations; 10 business days to begin and 60 days to complete for nurse-to-patient ratio violation complaints that do not involve imminent danger.

Section 1279.2 requires the department to document extenuating circumstances if it cannot meet investigation timeframes, and to provide written notice to both the complainant and the facility of its determination.

Section 1280.3(f)(1) now explicitly states that violations occurring on separate days shall be treated as separate violations for penalty escalation purposes, meaning a hospital could face escalating penalties ($15,000 then $30,000) across different days rather than having them all count as one violation.

The on-call list competency requirement in Section 1280.3(f)(4)(A)(iii) now requires nurses to possess and maintain verified competencies 'in writing,' adding a documentation requirement that was not in the original version.

New Section 1279.2(g) specifies that the costs of administering and implementing the new complaint investigation requirements shall be paid from existing licensing fees paid by general acute care hospitals, acute psychiatric hospitals, and special hospitals.

Nurses assigned to a hospital float pool (defined as nurses who are regularly scheduled but not assigned to a particular unit) may now count toward the hospital's on-call list. This broadens the pool of nurses that can satisfy the 10 percent minimum on-call list requirement, making it easier for general acute care hospitals to qualify for the exemption from the $15,000/$30,000 administrative penalty for nurse-to-patient ratio violations.

Removed empty subsection markers (d), (f), (g), and (h) in Section 1279.2 that were leftover from prior amendments, and renumbered the remaining subsections accordingly.

Fixed a duplicate word ('maintain maintain' changed to 'maintain') and corrected 'Section Sections' to 'Sections' in the bill title.