23 LC 33 9495
H. B. 745
- 1 -
House Bill 745
By: Representatives Kelley of the 16
th
, Hatchett of the 155
th
, Pirkle of the 169
th
, and
McCollum of the 30
th
A BILL TO BE ENTITLED
AN ACT
To amend Chapter 7 of Title 31 of the Official Code of Georgia Annotated, relating to
1
regulation and construction of hospitals and other health care facilities, so as to provide2
requirements for nurse staffing in hospitals; to provide for definitions; to require a written3
nurse services staffing plan; to provide for an official nurse services staffing plan; to provide4
for the establishment of nurse staffing committees; to provide for annual reporting of staffing5
information to the Department of Community Health; to provide for anonymous reports and6
investigations of unsafe staffing conditions; to establish an advisory commission; to provide7
for related matters; to repeal conflicting laws; and for other purposes.8
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:9
SECTION 1.10
Chapter 7 of Title 31 of the Official Code of Georgia Annotated, relating to regulation and11
construction of hospitals and other health care facilities, is amended by revising Article 2,12
which is reserved, as follows:13 23 LC 33 9495
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"ARTICLE 2
14
31-7-24.
15
Reserved.16
31-7-30.17
As used in this article, the term:18
(1) 'Committee' means a nurse staffing committee established pursuant to Code Section19
31-7-32.20
(2) 'Hospital' means a hospital which is permitted to operate by the department pursuant21
to Article 1 of this chapter, including a hospital maintained or operated by this state or22
a hospital authority.23
(3) 'Nurse services staffing plan' means the staffing plan required to be established by a24
hospital pursuant to Code Section 31-7-31.25
(4) 'Nurse staffing committee' means the standing committee established by a hospital26
pursuant to Code Section 31-7-32.27
(5) 'Patient care unit' means a unit or area of a hospital in which registered nurses provide28
patient care.29
31-7-31.30
(a) The governing body of a hospital shall adopt and implement a written nurse services31
staffing plan to ensure that an adequate number and skill mix of nurses are available to32
meet the level of patient care needed. Such plan shall include a process for:33
(1) Requiring the hospital to give significant consideration to the nurse services staffing34
plan recommended by the hospital's nurse staffing committee and to that committee's35
evaluation of any existing plan;36 23 LC 33 9495
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(2) Adopting and implementing an official nurse services staffing plan that is based on37
the needs of each patient care unit and shift and on evidence relating to patient care38
needs;39
(3) Using the official nurse services staffing plan as a component in setting the nurse40
staffing budget;41
(4) Encouraging nurses to provide input to the committee relating to nurse staffing42
concerns;43
(5) Protecting nurses who provide input to the committee from retaliation; and44
(6) Monitoring compliance with any rules and regulations adopted by the department45
relating to nurse staffing.46
(b) The written nurse services staffing plan adopted pursuant to subsection (a) of this Code47
section shall:48
(1) Reflect current standards established by private accreditation organizations,49
governmental entities, national nursing professional associations, or other healthcare50
professional organizations;51
(2) Set minimum staffing levels for patient care units that are:52
(A) Based on multiple nurse and patient considerations; and53
(B) Determined by the nursing assessment and in accordance with evidence based safe54
nursing standards;55
(3) Include a method for adjusting the nurse services staffing plan for each patient care56
unit to provide staffing flexibility to meet patient needs; and57
(4) Include a contingency plan when patient care needs unexpectedly exceed direct58
patient care staff resources.59
(c) A hospital shall:60
(1) Use the official nurse services staffing plan:61
(A) As a component in setting the nurse staffing budget; and62
(B) To guide the hospital in assigning nurses hospital wide; and63 23 LC 33 9495
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(2) Make readily available to nurses on each patient care unit at the beginning of each64
shift the official nurse services staffing plan levels and current staffing levels for that unit65
and that shift.66
31-7-32.67
(a) A hospital shall establish a nurse staffing committee as a standing committee of the68
hospital.69
(b) The committee shall be composed of members who are representative of the types of70
nursing services provided in the hospital.71
(c) The chief nursing officer of the hospital shall be a voting member of the committee.72
(d) At least 50 percent of the members of the committee shall be registered nurses who:73
(1) Provide direct patient care during at least 50 percent of their work time; and74
(2) Are selected by their peers who provide direct patient care during at least 50 percent75
of their work time.76
(e) The committee shall meet at least quarterly.77
(f) The committee shall:78
(1) Develop and recommend to the hospital's governing body a nurse services staffing79
plan that meets the requirements of Code Section 31-7-31;80
(2) Review, assess, and respond to staffing concerns expressed to the committee;81
(3) Identify the nurse-sensitive outcome measures the committee will use to evaluate the82
effectiveness of the official nurse services staffing plan;83
(4) Evaluate, at least semiannually, the effectiveness of the official nurse services84
staffing plan and variations between the plan and the actual staffing; and85
(5) Submit to the hospital's governing body, at least semiannually, a report on nurse86
staffing and patient care outcomes, including the committee's evaluation of the87
effectiveness of the official nurse services staffing plan and aggregate variations between88
the nurse services staffing plan and actual staffing.89 23 LC 33 9495
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(g) In evaluating the effectiveness of the official nurse services staffing plan, the90
committee shall consider patient needs, workforce shortages and availability,91
nurse-sensitive outcome measures, nurse satisfaction measures collected by the hospital,92
and evidence based nurse staffing standards.93
31-7-33.94
(a) A hospital shall annually report to the department, and the department shall include as95
a confidential addendum to the annual hospital questionnaire, the following information:96
(1) Whether the hospital's governing body has adopted a nurse services staffing plan as97
required by Code Section 31-7-31;98
(2) Whether the hospital has established a nurse staffing committee as required by Code99
Section 31-7-32 that meets the membership requirements of such Code section;100
(3) Whether the nurse staffing committee has evaluated the hospital's official nurse101
services staffing plan as required by Code Section 31-7-32 and has reported the results102
of the evaluation to the hospital's governing body as provided by such Code section; and103
(4) The nurse-sensitive outcome measures the committee adopted for use in evaluating104
the hospital's official nurse services staffing plan and an evaluation of the effectiveness105
of such measures.106
(b) To the extent possible, the department shall collect the data required pursuant to107
subsection (a) of this Code section in conjunction with surveys or other data required to be108
submitted to the department under other laws or regulations.109
(c) Such information shall not be subject to Article 4 of Chapter 18 of Title 50.110
31-7-34.111
(a) The department shall maintain a secure online portal for the submission by hospital112
staff members of anonymous reports of unsafe staffing conditions in any hospital.113 23 LC 33 9495
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(b) Upon receipt of a report of unsafe staffing conditions, the department shall forward the114
report to its Division of Healthcare Facility Regulation for investigation, to the nurse115
staffing committee of the hospital that is the subject of the report.116
(c) The Division of Healthcare Facility Regulation shall investigate all reports of unsafe117
staffing conditions pursuant to Code Section 31-2-8. If the division determines that a118
patient care unit identified in a complaint did not deliver nursing services in accordance119
with patients' needs and generally accepted standards of practice on the date identified in120
the complaint or during an on-site investigation, the division shall take appropriate actions121
as authorized in Code Section 31-2-8.122
31-7-35.123
(a) There is hereby established an advisory commission, composed of nine members as124
follows:125
(1) The following members appointed by the Governor:126
(A) An expert in nursing practice, quality of nursing care, or patient care standards;127
(B) A representative of associations representing nurses; and128
(C) A representative of a hospital;129
(2) The following members appointed by the President of the Senate:130
(A) An expert in nursing practice, quality of nursing care, or patient care standards;131
(B) A representative of associations representing nurses; and132
(C) A representative of a hospital; and133
(3) The following members appointed by the Speaker of the House of Representatives:134
(A) An expert in nursing practice, quality of nursing care, or patient care standards;135
(B) A representative of associations representing nurses; and136
(C) A representative of a hospital.137
The members of the advisory commission shall serve at the pleasure of the appointing138
official. Members of the advisory commission shall keep confidential any information139 23 LC 33 9495
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received in the course of their duties and shall only use such information in the course of140
carrying out their duties on the advisory commission, except those reports required to be141
issued by the commission under this Code section, which shall only include de-identified142
information.143
(b) The advisory commission shall convene annually in order to evaluate the effectiveness144
of the nurse staffing committees established pursuant to Code Section 31-7-32. Such145
review shall evaluate quantitative and qualitative data, including, but not limited to,146
whether staffing levels were improved and maintained, patient satisfaction, employee147
satisfaction, patient quality of care metrics, workplace safety, and any other metrics the148
advisory commission deems relevant.149
(c) The advisory commission may collect and shall be provided all relevant information150
necessary to carry out its functions from the department and other appropriate state151
agencies. The commission may also invite testimony by experts in the field and from the152
public. In making its recommendations pursuant to subsection (d) of this Code section, the153
advisory commission shall analyze relevant data, including data and factors contained in154
subsection (a) of Code Section 31-7-31 related to nurse services staffing plans. The155
advisory commission may also make recommendations for additional or enhanced156
enforcement mechanisms or powers to address hospital failure to comply with this article157
and recommend the appropriation of funding for the department to enforce this article or158
to assist hospitals in hiring additional staff to comply with this article.159
(d) The advisory commission shall submit to the Speaker of the House of Representatives,160
the President of the Senate, and the chairpersons of the House Committee on Health and161
Senate Health and Human Services Committee, and make available to the public, a report162
that includes recommendations for further legislative action, if any, in order to improve163
working conditions and quality of care in hospitals pursuant to the intent of this article.164
(e) Any information collected pursuant to Code Section 31-7-33 and provided to the165
advisory commission shall not be subject to Article 4 of Chapter 18 of Title 50."166 23 LC 33 9495
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SECTION 2.
167
All laws and parts of laws in conflict with this Act are repealed.168