More Than Half of Hospitals Inspected by State Do Not Meet Nurse Staffing Ratios, Los Angeles Times Finds
More than half of the hospitals inspected for alleged violations of state nurse-to-patient staffing ratio rules by state officials do not comply with the rules, according to a Los Angeles Times investigation of recent state inspection reports (Chong, Los Angeles Times, 12/31/04).
Under current state law, nurses may care for no more than six patients at one time. Gov. Arnold Schwarzenegger (R) in November delayed until January 2008 the implementation of a law, passed under former Gov. Gray Davis (D) and which was scheduled to take effect this month, that would require nurses to be responsible for the care of no more than five patients at one time (California Healthline, 12/7/04).
For the analysis, the Los Angeles Times examined state nurse staffing inspections of 28 hospitals between Jan. 1 and October 31, 2004, and found that 15 hospitals were cited for nurse staffing violations. The rules took effect Jan. 1, 2004.
The state inspects a hospital only after a complaint has been filed. Hospitals are not required to report staffing violations.
Three of the facilities inspected were cited for staffing violations, such as assigning responsibilities to licensed vocational nurses that should be delegated only to senior registered nurses, according to the reports. Most violations of the law occurred in emergency departments, medical surgical wards and telemetry units, according to the Los Angeles Times. According to the analysis, hospitals had the most difficulty complying with ratios during nurses' work breaks. Most hospitals cited for staffing violations had problems in only one ward, but six hospitals were cited for problems in multiple wards.
The hospitals in violation submitted correction plans that included suggestions such as hiring more full-time nurses, monitoring staff schedules and hiring additional nurses from independent agencies (Los Angeles Times, 12/31/04).
Brenda Klutz, deputy director of licensing and certification for the Department of Health Services, said, "The regulations were new this year, and there is always a period of adjustment while hospitals and staff implement the requirements" (AP/Contra Costa Times, 1/3).
Jill Furillo -- Southern California director of the California Nurses Association, which supports the nurse staffing ratios -- said that a recent CNA survey found that 58% of hospitals comply with the law. She said, "I think the fact that there are only 15 hospitals that have been cited is remarkable. It shows that there were enough nurses available and hospitals hired them."
California Hospital Association spokesperson Jan Emerson said, "What our survey data shows is that 85% of hospitals in the state are not able to comply with the law. It's not because they're not trying. It's because there aren't enough nurses." She added, "In some situations ... nurses ... are choosing to leave the full-time employed work force and instead join a registry and go back to the hospital as a registry nurse."
A public hearing on proposed changes to the staffing law is scheduled for Jan. 18 (Los Angeles Times, 12/31/04).