25 LC 46 9002
House Bill 298
By: Representatives Kelley of the 16
th
, Hawkins of the 27
th
, O’Steen of the 169
th
, Hatchett
of the 155
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 reports 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
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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) 'Hospital' means a hospital which is permitted to operate by the department pursuant19
to Article 1 of this chapter, including a hospital maintained or operated by a hospital20
authority; provided, however, that this shall not include a state owned or operated21
hospital.22
(2) 'Nurse services staffing plan' means the staffing plan required to be established by a23
hospital pursuant to Code Section 31-7-31.24
(3) 'Nurse staffing committee' or 'committee' means the standing committee established25
by a hospital pursuant to Code Section 31-7-32.26
(4) 'Patient care unit' means a unit or area of a hospital in which registered nurses provide27
patient care.28
31-7-31.29
(a) The governing body of a hospital shall adopt and implement a written nurse services30
staffing plan to ensure that an adequate number and skill mix of nurses are available to31
meet the level of patient care needed. Such plan shall include a process for:32
(1) Requiring the hospital to give significant consideration to the nurse services staffing33
plan recommended by the hospital's nurse staffing committee and to that committee's34
evaluation of any existing plan;35
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(2) Adopting and implementing an official nurse services staffing plan that is based on36
the needs of each patient care unit and shift and on evidence relating to patient care37
needs;38
(3) Using the official nurse services staffing plan as a component in setting the nurse39
staffing budget;40
(4) Encouraging nurses to provide input to the committee relating to nurse staffing41
concerns;42
(5) Protecting nurses who provide input to the committee from retaliation; and43
(6) Monitoring compliance with any rules and regulations adopted by the department44
relating to nurse staffing.45
(b) The written nurse services staffing plan adopted pursuant to subsection (a) of this Code46
section shall:47
(1) Reflect current standards established by private accreditation organizations,48
governmental entities, national nursing professional associations, or other healthcare49
professional organizations;50
(2) Set minimum staffing levels for patient care units that are:51
(A) Based on multiple nurse and patient considerations; and52
(B) Determined by the nursing assessment and in accordance with evidence based safe53
nursing standards;54
(3) Include a method for adjusting the nurse services staffing plan for each patient care55
unit to provide staffing flexibility to meet patient needs; and56
(4) Include a contingency plan when patient care needs unexpectedly exceed direct57
patient care staff resources.58
(c) A hospital shall:59
(1) Use the official nurse services staffing plan:60
(A) As a component in setting the nurse staffing budget; and61
(B) To guide the hospital in assigning nurses hospital wide; and62
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(2) Make readily available to nurses on each patient care unit at the beginning of each63
shift the official nurse services staffing plan levels and current staffing levels for that unit64
and that shift.65
31-7-32.66
(a) A hospital shall establish a nurse staffing committee as a standing committee of the67
hospital.68
(b) The committee shall be composed of members who are representative of the types of69
nursing services provided in the hospital.70
(c) The chief nursing officer of the hospital shall be a voting member of the committee.71
(d) At least 50 percent of the members of the committee shall be registered nurses who:72
(1) Provide direct patient care during at least 50 percent of their work time; and73
(2) Represent different inpatient care units, such as, but not limited to, medical, surgical,74
intensive care, and cardiac units.75
(e) The committee shall meet at least quarterly.76
(f) The committee shall:77
(1) Develop and recommend to the hospital's governing body a nurse services staffing78
plan that meets the requirements of Code Section 31-7-31;79
(2) Review, assess, and respond to staffing concerns expressed to the committee;80
(3) Identify the nurse-sensitive outcome measures the committee will use to evaluate the81
effectiveness of the official nurse services staffing plan;82
(4) Evaluate, at least semiannually, the effectiveness of the official nurse services83
staffing plan and variations between the plan and the actual staffing; and84
(5) Submit to the hospital's governing body, at least semiannually, a report on nurse85
staffing and patient care outcomes, including the committee's evaluation of the86
effectiveness of the official nurse services staffing plan and aggregate variations between87
the nurse services staffing plan and actual staffing.88
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(g) In evaluating the effectiveness of the official nurse services staffing plan, the89
committee shall consider patient needs, workforce shortages and availability,90
nurse-sensitive outcome measures, nurse satisfaction measures collected by the hospital,91
and evidence based nurse staffing standards.92
31-7-33.93
(a) A hospital shall annually report to the department, and the department shall include as94
a confidential addendum to the annual hospital questionnaire, the following information:95
(1) Whether the hospital's governing body has adopted a nurse services staffing plan as96
required by Code Section 31-7-31;97
(2) Whether the hospital has established a nurse staffing committee as required by Code98
Section 31-7-32 that meets the membership requirements of such Code section;99
(3) Whether the nurse staffing committee has evaluated the hospital's official nurse100
services staffing plan as required by Code Section 31-7-32 and has reported the results101
of the evaluation to the hospital's governing body as provided by such Code section; and102
(4) The nurse-sensitive outcome measures the committee adopted for use in evaluating103
the hospital's official nurse services staffing plan and an evaluation of the effectiveness104
of such measures.105
(b) To the extent possible, the department shall collect the data required pursuant to106
subsection (a) of this Code section in conjunction with surveys or other data required to be107
submitted to the department under other laws or regulations.108
(c) Such information shall not be subject to Article 4 of Chapter 18 of Title 50.109
31-7-34.110
(a) The department shall maintain a secure online portal for the submission by hospital111
staff members of anonymous reports of unsafe staffing conditions in any hospital.112
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(b) Upon receipt of a report of unsafe staffing conditions, the department shall forward the113
report to its Healthcare Facility Regulation Division for investigation and to the nurse114
staffing committee of the hospital that is the subject of the report.115
(c) The Healthcare Facility Regulation Division shall investigate all reports of unsafe116
staffing conditions pursuant to Code Section 31-2-8. If the division determines that a117
patient care unit identified in a complaint did not deliver nursing services in accordance118
with patients' needs and generally accepted standards of practice on the date identified in119
the complaint or during an on-site investigation, the division shall take appropriate actions120
as authorized in Code Section 31-2-8.121
31-7-35.122
(a) There is hereby established an advisory commission, composed of nine members as123
follows:124
(1) The following members appointed by the Governor:125
(A) An expert in nursing practice, quality of nursing care, or patient care standards;126
(B) A representative of an association representing nurses; and127
(C) A representative of a hospital;128
(2) The following members appointed by the President of the Senate:129
(A) An expert in nursing practice, quality of nursing care, or patient care standards;130
(B) A representative of an association representing nurses; and131
(C) A representative of a hospital; and132
(3) The following members appointed by the Speaker of the House of Representatives:133
(A) An expert in nursing practice, quality of nursing care, or patient care standards;134
(B) A representative of an association representing nurses; and135
(C) A representative of a hospital.136
(b) The members of the advisory commission shall serve at the pleasure of the appointing137
official. Members of the advisory commission shall keep confidential any information138
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received in the course of their duties and shall only use such information in the course of139
carrying out their duties on the advisory commission, except those reports required to be140
issued by the commission under this Code section, which shall only include de-identified141
information.142
(c) The advisory commission shall convene annually in order to evaluate the effectiveness143
of the nurse staffing committees established pursuant to Code Section 31-7-32. Such144
review shall evaluate quantitative and qualitative data, including, but not limited to,145
whether staffing levels were improved and maintained, patient satisfaction, employee146
satisfaction, patient quality of care metrics, workplace safety, and any other metrics the147
advisory commission deems relevant.148
(d) The advisory commission may collect and shall be provided all relevant information149
necessary to carry out its functions from the department and other appropriate state150
agencies. The commission may also invite testimony by experts in the field and from the151
public. In making its recommendations pursuant to subsection (e) of this Code section, the152
advisory commission shall analyze relevant data, including data and factors contained in153
subsection (a) of Code Section 31-7-31 related to nurse services staffing plans. The154
advisory commission may also make recommendations for additional or enhanced155
enforcement mechanisms or powers to address hospital failure to comply with this article156
and recommend the appropriation of funds for the department to enforce this article or to157
assist hospitals in hiring additional staff to comply with this article.158
(e) The advisory commission shall submit to the Speaker of the House of Representatives,159
the President of the Senate, and the chairpersons of the House Committee on Health and160
Senate Health and Human Services Committee, and make available to the public, a report161
that includes recommendations for further legislative action, if any, in order to improve162
working conditions and quality of care in hospitals pursuant to the intent of this article.163
(f) Any information collected pursuant to Code Section 31-7-33 and provided to the164
advisory commission shall not be subject to Article 4 of Chapter 18 of Title 50."165
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SECTION 2.
166
All laws and parts of laws in conflict with this Act are repealed.167
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