California is set to implement emergency staffing regulations for psychiatric hospitals Jan. 31, following an investigation into widespread dysfunction, abuse and understaffing, the San Francisco Chronicle reported Dec. 29.
The rules — issued by the California Department of Public Health under Gov. Gavin Newsom’s emergency authority — aim to close a regulatory loophole that excluded standalone psychiatric hospitals from nurse staffing requirements.
At the first public meeting to discuss the proposal, stakeholders raised concerns and recommended adjustments.
“It is impossible for the facilities to meet these requirements with this short notice,” Peggy Minnick, the CEO of Universal Health Services’ BHC Alhambra Hospital in Rosemead, Calif., said at the meeting. “What will happen is we will have to close psychiatric beds, which unfortunately will then have a negative impact on not only the provision of psychiatric care to people who need it, but it will cause emergency rooms to be inundated with psychiatric patients.”
Here are eight things to know:
- Facilities must staff at least one nurse for every six adult patients and one nurse for every five adolescent patients.
- At least 50% of nurses counted toward staffing ratios must be registered nurses. All nurses must be awake and on duty in the hospital.
- A separate registered nurse must be available to assess patients, but may not oversee more than 24 patients in a 12-hour shift or 16 patients in an 8-hour shift.
- Hospitals must assess suicide and violence risk and increase staffing beyond minimums as needed.
- Hospitals must establish a staffing committee with half of its members being nurses to maintain staffing policies.
- Staffing documentation must be kept for at least three years for licensed and certain unlicensed staff.
- California Department of Public Health can require additional staffing to meet patient needs and ensure safety.
- The department will have until July 31, 2027, finalize permanent regulations, incorporating feedback from front-line employees and hospital operators. The rules may still be amended before final implementation.
