Health facilities: administrative penalties.

Senator Menjivar's legislation revises California's health facility inspection protocols and penalty framework, establishing new requirements for investigating nurse-to-patient ratio complaints. The Department of Public Health must initiate inspections within 10 business days for non-emergency staffing complaints and complete investigations within 60 days.

The bill refines how administrative penalties apply to nurse staffing violations, with fines of $15,000 for initial infractions and $30,000 for subsequent violations. It introduces a precise definition of "on-call list" - limiting it to nurses scheduled for on-call shifts or assigned to float pools for specific units. The legislation specifies that contacting nurses outside these parameters does not qualify as exhausting the on-call list when facilities attempt to address staffing shortages.

For general acute care hospitals, the bill maintains exemptions from staffing ratio penalties when facilities can demonstrate that fluctuations were unpredictable and uncontrollable, prompt efforts were made to maintain required staffing levels, and the hospital properly utilized its on-call list and charge nurse. The Department must now treat violations occurring on different days as separate infractions rather than combining them into a single violation. Small and rural hospitals retain special consideration in enforcement to preserve access to care.