AB 489

This bill requires hospitals to develop and adhere to a plan for staffing

registered nurses. Under the bill, the nurse staffing plan must meet certain

standards, including being created and approved by a nurse staffing committee, the

majority of which must be registered nurses in nonsupervisory positions; reviewed

annually by the hospital; provided to the Department of Health Services annually,

by a deadline set by DHS; and posted in every unit of the hospital and on the DHS

website. The bill establishes minimum nurse-to-patient ratios that the hospital

must maintain for each unit in the hospital. Under the bill, hospitals must keep for

at least three years records of its nurse staffing ratios and actual staffing numbers.

Under the bill, a hospital that fails to provide DHS with its nurse staffing plan

by the deadline set by DHS is subject to a civil penalty of $25,000. In addition, a

hospital that fails to form a nurse staffing committee, annually review its nurse

staffing plan, annually submit its nurse staffing plan to DHS, or adhere to required

nurse-to-patient staffing ratios must submit a corrective action plan to DHS. Under

the bill, a hospital may be subject to a civil penalty of $5,000 for each day the hospital

fails to submit or comply with a corrective action plan.

In addition, the bill provides that registered nurses have the right to refuse a

work assignment if the nurse, in good faith and in the nurse's professional judgment,

finds that the nurse is unable to fulfill the assignment without compromising patient

safety or the nurse's license. The bill creates a cause of action for a nurse against a

hospital that disciplines, discharges, retaliates, discriminates, takes adverse action,

or files a complaint with a disciplinary agency against a nurse that refuses to

complete an assignment under those circumstances.

Under current law, subject to certain exceptions, an employer must pay an

employee who receives an hourly wage one and one-half times the employee's

regular rate of pay for all hours worked in excess of 40 hours per week, but current

law, with exceptions under child labor laws, does not prohibit an employer from

requiring an employee to work in excess of 40 hours per week.

This bill prohibits a hospital from requiring a registered nurse to work

overtime. Under the bill, overtime is work in excess of any of the following: 1) a

regularly scheduled predetermined shift immediately following that shift; 2) 12

hours in a 24-hour period; or 3) 40 hours in a scheduled workweek.

The prohibition on mandatory overtime under the bill does not apply in cases

in which the registered nurse is involved in an ongoing surgical procedure, the

registered nurse's presence is essential to the health and safety of a patient, the

nurse is working in a critical care unit, or a public health emergency has been

declared by the president of the United States or the governor, or during periods of

adverse weather, catastrophe, or widespread illness within the hospital.

A registered nurse who is discharged or discriminated against for refusing to

work overtime or for opposing a practice prohibited under the bill, for filing a