Health facilities: administrative penalties.

Senator Menjivar's proposal to modify California's health facility penalties framework introduces new documentation and staffing requirements for hospitals seeking exemption from nurse-to-patient ratio violations. The legislation amends existing administrative penalty provisions that currently assess $15,000 for first violations and $30,000 for subsequent infractions.

Under the proposed changes, hospitals must provide documentation demonstrating they have exhausted an on-call nurse list before qualifying for penalty exemptions. The bill defines qualifying on-call lists as comprising at least 10% of a facility's registered nursing staff, with all listed nurses maintaining verified competencies specific to their assigned units. These requirements supplement existing conditions that hospitals must meet, including showing that staffing fluctuations were unpredictable and that prompt efforts were made to maintain required levels.

The legislation maintains the current administrative penalty structure for other violations, with fines ranging from $75,000 for first violations to $125,000 for third and subsequent infractions. Hospitals can reset to first-violation status after three years without citations if they remain in substantial compliance with licensing requirements. The State Department of Public Health retains authority to consider special circumstances of small and rural hospitals when enforcing penalties to preserve access to care in these facilities.