Health facilities: administrative penalties.

Senator Menjivar's legislation refines California's administrative penalty framework for health facilities by establishing precise definitions for nurse staffing requirements and clarifying violation assessments. The bill maintains existing penalty amounts of $15,000 for first violations and $30,000 for subsequent violations of nurse-to-patient ratio regulations while introducing new parameters for how these violations are counted.

The measure provides an explicit definition of what constitutes an "on-call list" for staffing compliance purposes. Under the new provisions, only nurses formally scheduled for on-call shifts or assigned to float pools for specific units count toward a facility's required staffing levels. Attempts to contact nurses outside these designated categories would not qualify as exhausting the on-call list when facilities seek exemptions from staffing violation penalties.

For violations deemed to present immediate jeopardy to patient safety, the bill establishes a graduated penalty structure: up to $75,000 for first violations, $100,000 for second violations, and $125,000 for third and subsequent violations. Facilities can reset to first-violation status after three years without immediate jeopardy citations if they maintain substantial compliance with licensing requirements. The Department of Public Health must consider special circumstances affecting small and rural hospitals when enforcing these provisions.