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California Department of Public Health (CDPH) releases guidance on enforcement of life-saving nurse-to-patient ratios, including fines for hospitals that violate the law.

September 14, 2023

CDPH all-facilities letter follows union led campaign on post-pandemic enforcement.

Pasadena, CA - The Service Employees International Union Local 121RN (SEIU 121RN) released the following statement regarding the release of an all-facilities letter by the California Department of Public Health (CDPH), advising California hospitals of the Department’s intention to enforce existing law (SB 227), which mandates administrative penalties for general acute care hospitals that fail to comply with nurse-to-patient staffing ratios under Title 22. In addition to administrative penalties, the law requires the Department to conduct periodic, unannounced hospital inspections to verify staffing is in compliance with the law.

The letter also clarifies “unpredictable and uncontrollable” situations which may impact staffing and exempt facilities from administrative penalties.

“Nurses, who understand the impact of staffing on patient safety better than anyone, fought for California’s first-in-the-nation staffing ratios," said Rosanna Mendez, Executive Director of SEIU 121RN. "They continued to sound the alarm when they saw that the law was not being enforced. The guidance released by CDPH signals that will finally happen, and it comes as welcome news," Mendez said.

This year, SEIU 121RN nurses have led a public campaign calling for CDPH to enforce SB 227 following the expiration of California’s COVID-19 emergency order. In June, twenty-six state legislators signed a letter urging CDPH to ensure that safe staffing laws are enforced.

"As frontline patient advocates, union nurses will continue to be vigilant when it comes to safe staffing. They will watch closely to ensure that their hospitals are compliant with the law, and that their government is enforcing it. Ratios mean the difference between safe and unsafe care. They are a key ingredient in stemming the tide of turnover in nursing that has impacted hospitals across the country, and in our state,” Mendez said.

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SEIU Local 121RN represents registered nurses and other healthcare professionals in California. This member-led organization is committed to supporting optimum working conditions that allow nurses to provide quality patient care and safety.