Minimum Staffing Requirements May Cost Hospitals Between $200,000 and $2.3 Million Annually, Study Finds
Meeting state mandated nurse staffing requirements could increase hospital expenses by millions of dollars, a study by the Public Policy Institute of California has found, the AP/Contra Costa Times reports. The study, which examined three proposed staffing levels for general medical and surgical wards, determined that the ratios could increase hospital costs for registered nurses between 5% and 41% (AP/Contra Costa Times, 7/27). In 1999, California enacted a law requiring the Department of Health Services to establish minimum licensed nurse staffing ratios for all hospital units, complementing already existing requirements for intensive care units and operating rooms (California Healthline, 10/12/99). According to the law, the state must set the ratio by January (AP/Contra Costa Times, 7/27). Now, DHS is considering three proposals -- which the study analyzed -- from the California HealthCare Association, the California Nurses Association, and the Service Employees International Union (PPIC release, 7/27). In medical and surgical wards, CHA promotes a ratio of one nurse for every 10 patients, the CNA supports a one to three ratio and SEIU favors a one to four ratio. The study found the CHA plan could raise costs by $200,000 per facility per year, the SEIU plan could cost more than $1.3 million per facility per year and the CNA ratio could increase expenses as much as $2.3 million per hospital per year (AP/Contra Costa Times, 7/27).
At least half and as many as 95% of the state's hospitals would be affected by the minimum standards, no matter which proposal takes effect, the study says. In particular, larger and medium-sized hospitals will likely "experience the largest increase" in costs for nurses under the minimum staffing requirements, the study finds. And even though small and rural hospitals will have smaller cost increases, many of them are "struggling financially." Joanne Spetz, a research fellow with PPIC, said, "Policymakers may want to consider the potential effects of the minimum standards on financially troubled hospitals." She added, "Putting a price tag on various staffing options is a very important start, but we also need more information about the potential benefits of higher ratios on the quality of patient care" (PPIC release, 7/27). The CNA, however, maintains that the cost of hiring additional staff to meet staffing requirements will be "offset substantially" by a drop in the number of shifts covered by overtime, temporary and part-time workers (Rapaport, Sacramento Bee, 7/27).