Health facilities: administrative penalties.

Senator Menjivar's nurse staffing legislation establishes new requirements for California health facilities' nurse-to-patient ratios while revising inspection protocols and penalties for violations. The bill requires hospitals to maintain on-call nurse lists comprising at least 10% of registered nursing staff, with documented unit-specific competencies for all nurses on these lists. Float pool nurses may count toward the on-call requirement.

For complaints about nurse-to-patient ratio violations that do not pose immediate safety risks, the Department of Public Health must begin inspections within 10 business days and complete investigations within 60 days. The department will treat staffing violations occurring on different days as separate infractions rather than combining them. Hospitals face penalties of $15,000 for first violations and $30,000 for subsequent violations, though facilities can avoid penalties by documenting that staffing fluctuations were unpredictable and that they exhausted all options to maintain required levels.

The legislation designates regulations for psychiatric hospitals not operated by the State Department of State Hospitals as emergency measures necessary for public safety. Implementation costs will be funded through existing facility licensing fees, with provisions accounting for the circumstances of small and rural hospitals to maintain access to care. Facilities may request hearings within 10 working days to dispute violation determinations or proposed penalties.