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Saturday, Jun 10, 2023

Hospitals Still Struggle With Nurse Ratios

Since the beginning of the year, hospitals have been required by law to follow nurse to patient ratios as set forth by the state. Hospital administrators say that the regulations are hastening financial failures during a statewide nursing shortage. In an era of closing hospitals, healthcare officials agree that there is no single culprit for financial trouble. But when combined with the unfunded mandate of seismic improvements, which cost some hospitals tens of millions of dollars and patient treatment costs which are racing far ahead of public insurance payment rates, nurse ratios are on the minds of every hospital chief executive officer. “When the government comes in and says that we have to provide more nurse staffing or any staffing, that only increases labor costs,” said Jim Lott, executive vice president of the Hospital Association of Southern California. Lott said that when the law went into effect, the HASC put a surveillance program into place to find out how many hospitals were meeting the ratios. The study, he said, found that 87 percent of hospitals statewide were failing to meet the requirements. “You’ve got a disconnect between the mandate to hire more nurses and the availability of nurses to hire,” Lott said. Los Angeles, which is home to eight of the nine California hospitals to close this year, feels the effect of added costs more than any other city, said Jan Emerson, spokeswoman for the California Healthcare Association. The CHA has raised its voice in protest along with the SCHA. Emerson said that the state is partially to blame for such a small pool of nurses. “Even if all the money fell from heaven that we needed, we’d still have a problem with the ratios, because California does not have enough nurses to meet the requirements,” she said. “The state has the biggest responsibility for educating nurses, most of them are trained at state funded community colleges and the university system.” Low on list The CHA, in company news releases, cites 2001 data from the U.S. Bureau of Labor Statistics that lists California 49th among states in the number of nurses per capita. The organization also said that the state Economic Development Department says California will be short more than 30,000 registered nurses by 2006 and that the shortage will increase to 97,000 RNs by 2010. Lott and Emerson said that the HASC and other industry groups are not asking that the law be repealed, but they are pressing for a relaxation of some requirements. The first is a phrase in the law that says ratios have to be maintained “at all times.” This means that as nurses take breaks throughout the day, there must be a free nurse ready to pick up the slack. Rick Miller, vice president of business development and public affairs at West Hills Hospital & Medical Center said that the “at all times” requirement accounts for 25 percent of the $2 million that the hospital is paying to be in compliance with the ratios. “If they remove those three words, it would be a big help,” Miller said. Lisa Barry, a spokeswoman for Northridge Hospital Medical Center Sherman Way Campus, which is scheduled to close permanently in December, said that the cost of staying compliant with nursing ratios was one factor that led to the hospital losing over a million and a half dollars every month. Barry said hospitals that don’t have enough nurses are sometimes forced to lower the number of available beds throughout the hospital. Emerson agreed that flexibility in the “at all times” language would go a long way in helping hospitals to work under the required ratios. She said that as long as the language stays in the law, hospitals are essentially required to have one nurse for every four standing by and waiting to step in when a colleague takes a break. In May, the Sacramento County Superior Court sided with the Department of Health Services, which required that hospitals observe the ratios at all times. Now, both the CHA and the HASC are fighting to have the “at all times” portion of the law stricken.

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