The California Healthcare Association last week said that it was contemplating an appeal of a court ruling that upheld the state's landmark nurse-staffing law, which requires hospitals to maintain specific nurse-to-patient ratios at all times.
"The judge's ruling essentially handcuffs a hospital's ability to guarantee access to timely healthcare services for every patient who needs our care," CHA Vice President Dorel Harms said in a news release.
The CHA, which represents 450 of the state's hospitals, filed a lawsuit against the state Department of Health Services last December, challenging the requirement that the ratios be met even when a nurse takes a brief lunch, bathroom or coffee break as unfeasible. The suit contended that the "at all times" language, if taken literally, would "result in virtually all nursing units in the state failing to comply."
But Sacramento Superior Court Judge Gail Ohanesian ruled last week that the regulations clearly state that a nurse who is away from his or her assigned floor would not be counted for purposes of compliance. "The hospital must reassign the nurse's patients to another nurse and the reassigned patients must not cause the relieving nurse's patients to exceed the applicable ratios set forth in the regulation," Ohanesian wrote in her 12-page decision.
The CHA said it planned to "consider all of its options," including a possible appeal, said spokeswoman Jan Emerson in a news release.
Stephen Newman, chief executive officer of Tenet Healthcare Corp.'s California region, said the company continues to try to comply with the law, but it isn't easy. "As is true for 88% of the hospitals in California, we are not in compliance 100% of the time," Newman said, adding that Tenet supports the concept behind the ratios. He noted that California ranks 49th among the states in registered nurses per capita.
In a statement, the California Nurses Association called the ruling "a huge victory" that would "boost the efforts of RNs in several dozen other states."
California is the first and so far only state to pass such a specific nurse-staffing law. Under formal regulations that took effect Jan. 1, each nurse is limited to six patients in general medical-surgical units, four patients in emergency departments, two in intensive-care and labor units, and one in operating rooms.
-with Vince Galloro