Hospital Nurse Staffing

Laws, rules and administration of hospital nurse staffing in Oregon

On this page:

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

Nurse Staffing Resources

OHA has created a variety of resources to provide information and answer questions about new nurse staffing laws and rules. As part of this outreach OHA hosted three Open House Webinar events and each session has been archived here for later viewing. OHA has also put together an FAQ and specific guidance regarding the Plans of Correction that hospitals must submit after receiving a survey or complaint investigation report.

Administrative Rules

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.

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
  

Nurse staffing laws

Oregon's nurse staffing laws are found in Oregon Revised Statues 441.152 - 441.192. These laws reflect changes that resulted from Senate Bill 469 (SB 469), which the Oregon legislature passed in 2015 after working with a coalition of direct care nurses and hospitals to improve the nurse staffing laws.

The significant changes in 2015 were:

• Established composition and activities of Hospital Nurse Staffing Committees (HNSC);
• Provided factors for HNSCs to consider when formulating nurse staffing plans;
• Required mediation when HNSC cannot agree on nurse staffing plan;
• Clarified hospital record-keeping requirements;
• Created statewide Nurse Staffing Advisory Board (NSAB);
• Implemented timelines for OHA nurse staffing complaint investigations;
• Increased frequency of OHA nurse staffing audits; and
• Clarified OHA posting requirements for public records.

Additional information about SB 469 and OHA's implementation activities (pdf) 

HCRQI and HFLC

Health Care Regulation and Quality Improvement (HCRQI)

HCRQI oversees the implementation of nurse 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 is responsible for nurse staffing surveys and complaint investigations pursuant to Oregon statutes and administrative rules. HFLC staff work together to provide guidance to hospitals and nursing staff members throughout Oregon. HFLC also maintains a list of hospital nurse staffing committee co-chairs and chief nursing officers in order to provide notice in advance of nurse staffing audits. Hospitals should submit a change form (pdf) if the hospital nurse 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.

Select Join our Listserv to get started.

Waivers

HFLC may waive one or more of the staffing plan requirements in OAR 333-510-0110 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)
  

NSAB Meeting Schedule

Nurse Staffing Survey Process

Since 2017

HFLC staff uses a standardized survey process intended to evaluate hospital compliance with the rules related to nurse staffing. Hospitals are be randomly selected for survey from the list of hospitals licensed in the state of Oregon.

• Each hospital is audited once every three years to assess nurse staffing compliance;
• Audits include review of relevant records, interviews of both Hospital Nurse Staffing Committee (HNSC) co-chairs, and interviews of any other person(s) deemed necessary to determine compliance;
• Hospitals keep and maintain records that demonstrate compliance;
• After an audit, OHA sends the hospital and the HNSC co-chairs a written report that explains any nurse staffing concerns found during the survey. A hospital submits a plan of correction to address any concerns noted in the OHA's report. Once a plan of correction is approved, OHA will revisit the hospital within 60 days to determine compliance; and
• OHA maintains and posts audit reports online (see below).

Nurse Staffing Complaint Process

Since 2017

HFLC staff uses tools developed in the audit process to investigate specific nurse staffing complaints.

• OHA surveyors review complaints sent to the OHA and seek any additional information they need. Once surveyors have a completed complaint intake, they conduct an onsite investigation within 60 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 and the HNSC co-chairs a written report that explains any nurse staffing concerns found during the investigation. A hospital submits a plan of correction to address any concerns noted in the OHA's report. Once a plan of correction is approved, OHA will revisit the hospital within 60 days to determine compliance; and
• OHA maintains and posts complaint reports online (see below).

View Reports from Nurse Staffing Surveys and Complaint Investigations

Listed below are reports generated from nurse staffing surveys and 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