Nurse Staffing Ratio, Bill SB277

 In Workforce News

Nurse Leaders in California have enough challenges when it comes to staffing. For years they have struggled with nursing shortages, rising cost of labor, high-turnover, threat of union strikes and obtaining quality supplemental staff to meet erratic staffing levels at reasonable rates. Meeting staffing ratio requirements is a big concern for all healthcare facilities in California and there is much that goes into ensuring staffing requirements are appropriately met.

According to the bill, penalties collected by the department are deposited into the Internal Departmental Quality Improvement Account, to be expended, upon appropriation by the Legislature, for internal quality improvement activities in the Licensing and Certification Program.  According to many of our nurse travel staffing resources, it currently takes an average of three months or more for an out of state nurse to obtain a temporary RN license through the CA Board of Nursing (BON). This is a considerable improvement over years prior, but still ties the hands of Nurse Leaders in obtaining temporary nursing resources in a timely manner.

I think we all can agree appropriate staffing ratios result in better patient care, and if a facility is consistently negligent on meeting these requirements then penalties are already in place. However, this legislation will likely result in driving up labor costs and putting hospitals in a compromised position of having to choose a less qualified nurse in order to avoid additional penalties associated with this bill. We all support the efforts of nurses and healthcare facilities in ensuring timely and quality care of staff however, SB277 creates an unnecessary, duplicative penalty system for hospitals in California and does not solve the problem of ensuring adequate staffing levels are consistently met.

AdaptiveWFS supports the efforts of CHA and ACNL in voting down Nurse Staffing Ratio SB277 Bill.


Here is how you can make a difference:

ACNL has received this urgent notice from CHA regarding the Nurse Staffing Ratio Bill, SB227.

Action needed:

CHA urges hospital executives to send a letter asking Governor Newsom to veto Senate Bill (SB) 227 (Leyva, D-Chino), which would create an unreasonable and duplicative penalty system for hospitals that do not meet nurse staffing ratios. CHA has developed a template letter for members’ use. To find contact information for your representative, visit

Important facts regarding Nurse Staffing Ratio, SB277


  • Existing law requires the department to promulgate regulations establishing criteria to assess an administrative penalty against a general acute care hospital, acute psychiatric hospital, or special hospital for a deficiency constituting an immediate jeopardy violation and a violation of the rules and regulations applicable to these types of hospitals that do not constitute an immediate jeopardy. Existing law requires certain penalties collected by the department to be deposited into the Internal Departmental Quality Improvement Account, to be expended, upon appropriation by the Legislature, for internal quality improvement activities in the Licensing and Certification Program.
  • This bill would require the department to assess specified administrative penalties for a violation of the nurse-to-patient ratios and staff assignment regulations described above. The bill would exempt from those administrative penalties a general acute care hospital that demonstrates to the satisfaction of the department that, among other things, prompt efforts were made to maintain required staffing levels, as specified.
  • Administrative penalty against a licensee of a health facility for a deficiency constituting an immediate jeopardy violation has a maximum penalty of seventy-five thousand dollars ($75,000) for the first administrative penalty, up to one hundred thousand dollars ($100,000) for the second subsequent administrative penalty, and up to one hundred twenty-five thousand dollars ($125,000) for the third and every subsequent violation.

The measure is co-sponsored by SEIU California, SEIU Local 121RN and United Nurses Associations of California / Union of Health Care Professionals (UNAC / UHCP) and supported by the American Federation of State, County, and Municipal Employees, California Labor Federation, California Nurses Association / National Nurses United, California Professional Firefighters, California School Employees Association, California School Nurses Organization, California Teamsters Public Affairs Council, Congress of California Seniors, Consumer Attorneys of California, Engineers and Scientists of California / Local 20, International Longshore and Warehouse Union / Local 13 and San Francisco AIDS Foundation.


Additional information and articles about Nurse Staffing Ratio Bill SB 277



AdaptiveWFS develops innovative and technical workforce management programs that can meet the demands of today’s staffing challenges.

Find out how the Adaptive Advantage can benefit your facility with a free consultation.


Oops! We could not locate your form.

physician-shortage-detrimental-to-patient-care Partnership To Reduce Contract Labor Costs