Hospital Staffing

Laws, rules and administration of hospital staffing in Oregon

On this page:

• Hospital Staffing Information 
  
• Administrative Rules
  
• Hospital Staffing Laws
• Health Care Regulation and Quality Improvement Section (HCRQI) & Health Facility Licensing and Certification Program (HFLC)
• Waivers
• Nurse Staffing Advisory Board (NSAB)
• Hospital Staffing Complaint Process

Hospital Staffing Information

OHA is creating a variety of resources to provide information and answer questions about hospital staffing laws following the passage of HB 2697. OHA will use the hospital staffing listservs to announce new resources as they become available.

• OHA presented a brief overview (pdf) of key aspects of the bill at the Nurse Staffing Advisory Board meeting on July 26, 2023. 
• House Bill (HB) 2697 Hospital Staffing Law Implementation Frequently Asked Questions (FAQ) (pdf)
  

2015 and 2021 statutory changes necessitated changes to the nurse staffing administrative rules. OHA amended the rules and the administrative rules went into effect on July 1, 2016, January 23, 2017, and January 1, 2022. There will be updates coming soon as OHA implements HB 2697. Information on the rulemaking activity and the Rulemaking Advisory Committee can be found under Rulemaking Advisory Committees In Progress on www.healthoregon.org/hcrqirules.

Oregon Administrative Rules Chapter 333, Division 501 includes:

• OAR 333-501-0035 - Nurse Staffing Audit Procedures
  
• OAR 333-501-0040 - Complaint Investigation Procedures
• OAR 333-501-0045 - Civil Penalties for Violations of Nurse Staffing Laws and Table 1: Civil Penalty Assessments (pdf)

Oregon Administrative Rules Chapter 333, Division 510 includes:

• OAR 333-510-0002 - Definitions
• OAR 333-510-0045 - Nurse Staffing Posting and Record Requirements
• OAR 333-510-0105 - Nurse Staffing Committee Requirement
• OAR 333-510-0110 - Nurse Staffing Plan Requirements
• OAR 333-510-0115 - Nurse Staffing Plan Review Requirement
• OAR 333-510-0120 - Nurse Staffing Plan Mediation
• OAR 333-510-0125 - Replacement Nurse Staffing Requirements
• OAR 333-510-0130 - Nurse Staffing Member Overtime
• OAR 333-510-0135 - Nurse Staffing Plan Waiver
• OAR 333-510-0140 - Nurse Staffing Plan During an Emergency
  

Hospital staffing laws

Oregon's nurse staffing laws are found in Oregon Revised Statues 441.152 - 441.192. Significant changes to Oregon hospital staffing laws made in 2023 are not reflected in the Oregon Revised Statutes. The text of the new law is available on the legislature's page for HB 2697.

HCRQI and HFLC

Health Care Regulation and Quality Improvement (HCRQI)

HCRQI oversees the implementation of hospital staffing laws in Oregon.

Health Facility Licensing and Certification (HFLC)

HFLC licenses hospitals in Oregon. HFLC staff support the Nurse Staffing Advisory Board (NSAB) and HFLC's Surveyor and Certification program is responsible for hospital staffing complaint investigations pursuant to Oregon statutes. HFLC staff work together to provide guidance to hospitals and hospital staff members throughout Oregon. HFLC also maintains a list of hospital staffing committee co-chairs and chief nursing officers. Hospitals should submit a change form if the hospital staffing committee co-chairs or chief nursing officer changes.

Join our Listserv

The OHA Hospital Nurse Staffing Listserv is used to send announcements and information regarding hospital nurse staffing rules and related events put on by the Health Facility Licensing and Certification Program. OHA will be creating listservs for professional/technical staffing and services staffing shortly.

Select Join our Listserv to get started.

Waivers

HFLC may waive one or more of the nurse staffing plan requirements if the waiver is necessary to ensure that the hospital is staffed to meet the health care needs of its patients.

Waiver requests must

• Be submitted in writing;
• State the reason the hospital is seeking the waiver;
• Explain how the waiver is necessary for the hospital to meet patient health care needs; and
• Include verification that the hospital nurse staffing committee has been notified of the request for waiver.

Hospitals can use the Nurse Staffing Waiver Request Form (pdf) to prepare the written request.

NSAB

The Nurse Staffing Advisory Board (NSAB) is a 12-member board of hospital nurse managers, direct care registered nurses, and a direct care staff member. The OHA has create an NSAB FAQ (pdf) for direct care nursing staff members and nurse managers to learn more about the Oregon NSAB and how to apply for membership.

NSAB Members (pdf) are charged with

• Providing advice to the Oregon Health Authority on the administration of Oregon's nurse staffing laws;
• Identifying trends, opportunities and concerns related to nurse staffing;
• Making recommendations to the Oregon Health Authority on the basis of those trends, opportunities and concerns;
• Reviewing the enforcement powers and processes under Oregon's nurse staffing laws.

The NSAB submits an annual report to the legislature on the administration of Oregon's nurse staffing laws.

• 2016 Legislative Report (pdf)
• 2017 Legislative Report (pdf)
  
• 2018 Legislative Report (pdf)
• 2019 Legislative Report (pdf)
• 2020 Legislative Report (pdf)
• 2021 Legislative Report (pdf)
• 2022 Legislative Report (pdf)
• 2023 Legislative Report (pdf)
  

NSAB Meeting Schedule

Hospital Staffing Complaint Process

HFLC staff will be developing new tools for hospital staffing complaint investigations to align with the bases for noncompliance citations specified in HB 2697. 

• OHA surveyors review complaints sent to the OHA and seek any additional information they need. Once surveyors have a completed complaint intake, OHA
  
• Provides a copy of the complaint to the staff member's Exclusive Representative
• Notifies the hospital, staffing committee co-chairs, and Exclusive Representative of the pending complaint;
• Receives documentation regarding the allegations from the hospital; and
• Conducts an investigation within 80 days;
• Investigations include review of relevant records and interviews of any person(s) deemed necessary to determine compliance;
• After an investigation, OHA sends the hospital, the staffing committee co-chairs, and the Exclusive Representative a written report that explains any hospital staffing concerns found during the investigation. OHA will be able to assess civil monetary penalties for violations that occur on or after June 1, 2025; and
• OHA maintains and posts complaint reports online (see below).

View Reports from Nurse Staffing Surveys and Hospital Staffing Complaint Investigations

Listed below are reports generated from nurse staffing surveys and hospital staffing complaint investigations.

• You can search this listing by facility name, city, county or zip code. TIP: Start typing in the search box to filter the list.
• All documents are in PDF format.
  

Annual Summary Reports