State Data Shows 36% of Hospitals Meet Nurse Staffing Requirements
About 36% of California hospitals are in compliance with state nurse-to-patient ratio rules, according to data from the Department of Health Services from the first 10 months of 2004, the Los Angeles Times reports. According to the Times, the findings come as Gov. Arnold Schwarzenegger's (R) administration and some state hospitals are attempting to "scale back the ratios" (Chong, Los Angeles Times, 2/6).
DHS officials in November 2004 proposed to delay until at least January 2008 a decrease -- originally scheduled for Jan. 1, 2005 -- in the required nurse-to-patient ratio for medical-surgical units from 1-to-6 to 1-to-5. DHS also would allow hospitals to suspend temporarily compliance with nurse staffing rules for EDs in the event of an "unforeseeable influx" of patients. In addition, DHS proposed reversing a requirement that hospitals replace nurses on bathroom breaks.
DHS has submitted the proposals to the Office of Administrative Law, which is expected to approve them. DHS likely will hold a public hearing on the proposals in mid-January (California Healthline, 11/30/04).
A Times review of hospital inspection records of 28 hospitals completed by October 2004 found that 10 hospitals met staffing ratio requirements.
Although the hospitals that met ratio guidelines varied in size and location, the Times reports that the hospitals all renegotiated rates with private health insurance companies and encouraged insurers to refer more patients to their hospitals to offset the costs of hiring more nurses.
In addition, most of the hospitals found to be in compliance with the law reported net income increases in 2003. Turnover rates and job vacancy rates at hospitals in compliance with the rules are below the state average rates of about 15%, which some hospital officials attribute to efforts to maintain employee satisfaction and nationally known specialties at the facilities that attract nurses.
Officials said their facilities also have low usage of temporary nurses, which can help control costs.
However, officials at hospitals that meet the staffing ratio requirements say it is difficult to maintain proper staffing levels and that staffing might not be in compliance at all times because of fluctuations in the number of patients seeking care.
The estimated percentage of hospitals in compliance with the staffing ratio varies. The California Hospital Association estimates a 15% compliance rate, while the California Nurses Association said information from 175 hospitals in the state shows an 80% compliance rate.
Jill Furillo, Southern California director for CNA, said, "What the data is showing and what our information is showing is, where there is a will, there is a way to meet the ratios" (Los Angeles Times, 2/6).