Georgia 2025-2026 Regular Session

Georgia House Bill HB298 Compare Versions

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1-25 LC 46 1163S
2-The House Committee on Health offers the following substitute to HB 298:
1+25 LC 46 9002
2+House Bill 298
3+By: Representatives Kelley of the 16
4+th
5+, Hawkins of the 27
6+th
7+, O’Steen of the 169
8+th
9+, Hatchett
10+of the 155
11+th
12+, and McCollum of the 30
13+th
14+
315 A BILL TO BE ENTITLED
416 AN ACT
5-To amend Chapter 7 of Title 31 of the Official Code of Georgia Annotated, relating to1
17+To amend Chapter 7 of Title 31 of the Official Code of Georgia Annotated, relating to
18+1
619 regulation and construction of hospitals and other health care facilities, so as to provide2
720 requirements for nurse staffing in hospitals; to provide for definitions; to require a written3
8-nurse services staffing plan; to provide for the establishment of nurse staffing committees;4
9-to provide for annual reports of staffing information to the Department of Community5
10-Health; to provide for anonymous reports and investigations of unsafe staffing conditions;6
11-to establish an advisory commission; to provide for related matters; to repeal conflicting7
12-laws; and for other purposes.8
21+nurse services staffing plan; to provide for an official nurse services staffing plan; to provide4
22+for the establishment of nurse staffing committees; to provide for annual reports of staffing5
23+information to the Department of Community Health; to provide for anonymous reports and6
24+investigations of unsafe staffing conditions; to establish an advisory commission; to provide7
25+for related matters; to repeal conflicting laws; and for other purposes.8
1326 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:9
1427 SECTION 1.10
1528 Chapter 7 of Title 31 of the Official Code of Georgia Annotated, relating to regulation and11
1629 construction of hospitals and other health care facilities, is amended by revising Article 2,12
1730 which is reserved, as follows:13
18-H. B. 298 (SUB)
19-- 1 - 25 LC 46 1163S
20-"ARTICLE 214
21-31-7-24.15
31+H. B. 298
32+- 1 - 25 LC 46 9002
33+"ARTICLE 2
34+14
35+31-7-24.
36+15
2237 Reserved.16
2338 31-7-30.17
2439 As used in this article, the term:18
2540 (1) 'Hospital' means a hospital which is permitted to operate by the department pursuant19
2641 to Article 1 of this chapter, including a hospital maintained or operated by a hospital20
2742 authority; provided, however, that this shall not include a state owned or operated21
2843 hospital.22
29-(2) 'Nurse services staffing plan' means the written staffing plan required to be23
30-established by a hospital pursuant to Code Section 31-7-31.24
44+(2) 'Nurse services staffing plan' means the staffing plan required to be established by a23
45+hospital pursuant to Code Section 31-7-31.24
3146 (3) 'Nurse staffing committee' or 'committee' means the standing committee established25
3247 by a hospital pursuant to Code Section 31-7-32.26
33-(4) 'Patient care unit' means a hospital's emergency department and any unit or27
34-department of a hospital in which registered nurses provide direct patient care to28
35-inpatients.29
36-31-7-31.30
37-(a) The governing body of a hospital shall adopt and implement a written nurse services31
38-staffing plan to provide that an adequate number and skill mix of nurses are available to32
39-meet the level of patient care needed for the hospital's patient care units. Such plan shall33
40-include a process for:34
41-(1) Requiring the hospital to give significant consideration to the nurse services staffing35
42-plan recommended by the hospital's nurse staffing committee and to that committee's36
43-evaluation of any existing plan;37
44-H. B. 298 (SUB)
45-- 2 - 25 LC 46 1163S
46-(2) Adopting and implementing a nurse services staffing plan that is based on an38
47-assessment of the needs of each patient care unit and shift, including evidence relating39
48-to patient care needs of each patient care unit at the hospital;40
49-(3) Considering the nurse services staffing plan as a component in setting the nurse41
50-staffing budget;42
51-(4) Encouraging nurses to provide input to the committee relating to nurse staffing43
52-concerns;44
53-(5) Protecting nurses who provide input to the committee from retaliation; and45
54-(6) Monitoring compliance with any rules and regulations adopted by the department46
55-relating to nurse staffing.47
56-(b) The nurse services staffing plan adopted pursuant to subsection (a) of this Code section48
57-shall:49
58-(1) Consider the nurse staffing standards established by the Joint Commission or other50
59-nationally recognized accreditation organizations, by the department, or by nationally51
60-recognized hospital associations;52
61-(2) Set minimum staffing levels for patient care units:53
62-(A) Based on multiple nurse and patient considerations; and54
63-(B) Determined by the nursing assessment and in accordance with evidence based safe55
64-nursing standards;56
65-(3) Include a method for periodically adjusting the nurse services staffing plan for each57
66-patient care unit to address significant changes in utilization or other circumstances that58
67-impact nurse staffing and require staffing flexibility to meet patient needs; and59
68-(4) Include a contingency plan when patient care needs unexpectedly exceed direct60
69-patient care staff resources.61
70-(c) A hospital shall:62
71-(1) Consider the nurse services staffing plan:63
72-(A) As a component in setting the nurse staffing budget; and64
73-H. B. 298 (SUB)
74-- 3 - 25 LC 46 1163S
75-(B) To guide the hospital in assigning nurses to patient care units; and65
76-(2) Make readily available to nurses on each patient care unit at the beginning of each66
77-shift the nurse services staffing plan levels and current staffing levels for that unit and67
78-that shift.68
79-31-7-32.69
80-(a) A hospital shall establish a nurse staffing committee as a standing committee of the70
81-hospital.71
82-(b) The committee shall be composed of members who are representative of the types of72
83-nursing services provided in the hospital's patient care units.73
84-(c) The chief nursing officer of the hospital shall be a voting member of the committee.74
85-(d) At least 75 percent of the members of the committee shall be registered nurses who:75
86-(1) Provide direct patient care during at least 50 percent of their work time; and76
87-(2) Represent different patient care units provided by the hospital.77
88-(e) The committee shall meet at least quarterly.78
89-(f) The committee shall:79
90-(1) Develop and recommend to the hospital's governing body a nurse services staffing80
91-plan that meets the requirements of Code Section 31-7-31;81
92-(2) Review, assess, and respond to staffing concerns expressed to the committee;82
93-(3) Identify the nurse-sensitive outcome measures the committee will use to evaluate the83
94-effectiveness of the nurse services staffing plan for the patient care units;84
95-(4) Evaluate, at least semiannually, the effectiveness of the nurse services staffing plan,85
96-including the reasons for any significant variations between the plan and the actual86
97-staffing; and87
98-(5) Submit to the hospital's governing body, at least semiannually, a report on nurse88
99-staffing and outcomes on the nurse-sensitive outcome measures reviewed by the89
100-committee, including the committee's evaluation of the effectiveness of the nurse services90
101-H. B. 298 (SUB)
102-- 4 - 25 LC 46 1163S
103-staffing plan and aggregate variations between the nurse services staffing plan and actual91
104-staffing.92
105-(g) In evaluating the effectiveness of the nurse services staffing plan, the committee shall93
106-consider, but is not limited to considering, patient needs, workforce shortages and94
107-availability, the nurse-sensitive outcome measures reviewed by the committee, any nurse95
108-satisfaction measures collected by the hospital for the patient care units, and any nationally96
109-recognized, written, evidence based nurse staffing benchmarks.97
110-(h) All proceedings, records, and reports of the committee shall be deemed confidential98
111-review organization records under Code Section 31-7-133 and shall not be subject to99
112-Article 4 of Chapter 18 of Title 50. The nurse staffing plan adopted by a hospital shall not100
113-be subject to discovery or introduction into evidence in any civil action; and no person who101
114-was in attendance at a meeting of such committee shall be permitted or required to testify102
115-in any such civil action as to any evidence or other matters produced or presented during103
116-the proceedings or activities of the committee or as to the findings, recommendations,104
117-evaluations, opinions, or other actions of such committee or any members thereof.105
118-31-7-33.106
119-(a) A hospital shall annually report to the department, and the department shall include as107
120-a confidential addendum to the annual hospital questionnaire, the following information:108
121-(1) Whether the hospital's governing body has adopted a nurse services staffing plan as109
122-required by Code Section 31-7-31;110
123-(2) Whether the hospital has established a nurse staffing committee as required by Code111
124-Section 31-7-32 that meets the membership requirements of such Code section;112
125-(3) Whether the nurse staffing committee has evaluated the hospital's nurse services113
126-staffing plan as required by Code Section 31-7-32 and has reported the results of the114
127-evaluation to the hospital's governing body as provided by such Code section; and115
128-H. B. 298 (SUB)
129-- 5 - 25 LC 46 1163S
130-(4) The nurse-sensitive outcome measures the committee adopted for use in evaluating116
131-the hospital's nurse services staffing plan.117
132-(b) To the extent possible, the department shall collect the information required pursuant118
133-to subsection (a) of this Code section in conjunction with surveys or other data required to119
134-be submitted to the department under other laws or regulations.120
135-(c) The reports provided by the hospitals under subsection (a) of this Code section shall121
136-not be subject to Article 4 of Chapter 18 of Title 50.122
137-31-7-34.123
138-(a) The department shall maintain a secure online portal for the submission by hospital124
139-staff members of anonymous reports of unsafe staffing conditions in any hospital patient125
140-care unit, provided that the forms for reporting shall require specificity, including the126
141-patient care unit; the date, time, and description of the conditions deemed unsafe; and any127
142-supporting information.128
143-(b) Upon receipt of a report that complies with subsection (a) of this Code section, the129
144-department shall forward the report to its Healthcare Facility Regulation Division for130
145-possible investigation and to the nurse staffing committee of the hospital that is the subject131
146-of the report.132
147-(c) If the Healthcare Facility Regulation Division determines that a patient care unit133
148-identified in a report made under subsection (a) of this Code section failed to comply with134
149-nurse staffing requirements established by the department or violated any rule or regulation135
150-relating to the licensing of hospitals on the date identified in the complaint or during an136
151-on-site investigation, the Healthcare Facility Regulation Division is authorized to take137
152-appropriate actions under the provisions of Code Section 31-2-8.138
153-(d) The reports provided by hospital staff members under subsection (a) of this Code139
154-section shall not be subject to Article 4 of Chapter 18 of Title 50.140
155-H. B. 298 (SUB)
156-- 6 - 25 LC 46 1163S
157-31-7-35.141
158-(a) There is hereby established an advisory commission, composed of 12 members as142
159-follows:143
160-(1) The following members appointed by the Governor:144
161-(A) An expert in nursing practice, quality of nursing care, or patient care standards;145
162-(B) A representative of an association representing nurses; and146
163-(C) Two representatives of an association representing hospitals;147
164-(2) The following members appointed by the President of the Senate:148
165-(A) An expert in nursing practice, quality of nursing care, or patient care standards;149
166-(B) A registered nurse who provides direct patient care at a hospital at least 50 percent150
167-of the work time; and151
168-(C) Two representatives of a hospital in a rural county; and152
169-(3) The following members appointed by the Speaker of the House of Representatives:153
170-(A) An expert in nursing practice, quality of nursing care, or patient care standards;154
171-(B) A representative of an association representing nurses; and155
172-(C) Two representatives of a hospital.156
173-(b) The members of the advisory commission shall serve at the pleasure of the appointing157
174-official. Members of the advisory commission shall keep confidential any information158
175-received in the course of their duties and shall only use such information in the course of159
176-carrying out their duties on the advisory commission, except those reports required to be160
177-issued by the commission under this Code section, which shall only include de-identified161
178-information that cannot reasonably be used to identify any person, hospital, or other entity.162
179-(c) The advisory commission shall convene annually in order to evaluate the effectiveness163
180-of the nurse staffing committees established pursuant to Code Section 31-7-32. Such164
181-review shall evaluate quantitative and qualitative data, including, but not limited to,165
182-whether staffing levels were improved and maintained, patient satisfaction, employee166
183-H. B. 298 (SUB)
184-- 7 - 25 LC 46 1163S
185-satisfaction, patient quality of care metrics, workplace safety, and any other metrics the167
186-advisory commission deems relevant.168
187-(d) The advisory commission may collect and shall be provided all relevant information169
188-necessary to carry out its functions from the department and other appropriate state170
189-agencies. The commission may also invite testimony by experts in the field and from the171
190-public. In making its recommendations pursuant to subsection (e) of this Code section, the172
191-advisory commission shall analyze relevant data provided by the department or other state173
192-agencies, including data and factors contained in subsection (a) of Code Section 31-7-31174
193-related to nurse services staffing plans. The advisory commission may also make175
194-recommendations for additional or enhanced enforcement mechanisms or powers to176
195-address hospital failure to comply with this article and recommend the appropriation of177
196-funds for the department to enforce this article or to assist hospitals in recruiting or hiring178
197-additional nursing staff.179
198-(e) The advisory commission shall submit to the Speaker of the House of Representatives,180
199-the President of the Senate, and the chairpersons of the House Committee on Health and181
200-Senate Health and Human Services Committee, and make available to the public, a report182
201-that may include recommendations for further legislative action, if any, in order to improve183
202-nurse staffing in hospitals pursuant to the intent of this article.184
203-(f) Any information collected pursuant to Code Section 31-7-33 and provided to the185
204-advisory commission shall not be subject to Article 4 of Chapter 18 of Title 50."186
205-SECTION 2.187
206-All laws and parts of laws in conflict with this Act are repealed.188
207-H. B. 298 (SUB)
48+(4) 'Patient care unit' means a unit or area of a hospital in which registered nurses provide27
49+patient care.28
50+31-7-31.29
51+(a) The governing body of a hospital shall adopt and implement a written nurse services30
52+staffing plan to ensure that an adequate number and skill mix of nurses are available to31
53+meet the level of patient care needed. Such plan shall include a process for:32
54+(1) Requiring the hospital to give significant consideration to the nurse services staffing33
55+plan recommended by the hospital's nurse staffing committee and to that committee's34
56+evaluation of any existing plan;35
57+H. B. 298
58+- 2 - 25 LC 46 9002
59+(2) Adopting and implementing an official nurse services staffing plan that is based on36
60+the needs of each patient care unit and shift and on evidence relating to patient care37
61+needs;38
62+(3) Using the official nurse services staffing plan as a component in setting the nurse39
63+staffing budget;40
64+(4) Encouraging nurses to provide input to the committee relating to nurse staffing41
65+concerns;42
66+(5) Protecting nurses who provide input to the committee from retaliation; and43
67+(6) Monitoring compliance with any rules and regulations adopted by the department44
68+relating to nurse staffing.45
69+(b) The written nurse services staffing plan adopted pursuant to subsection (a) of this Code46
70+section shall:47
71+(1) Reflect current standards established by private accreditation organizations,48
72+governmental entities, national nursing professional associations, or other healthcare49
73+professional organizations;50
74+(2) Set minimum staffing levels for patient care units that are:51
75+(A) Based on multiple nurse and patient considerations; and52
76+(B) Determined by the nursing assessment and in accordance with evidence based safe53
77+nursing standards;54
78+(3) Include a method for adjusting the nurse services staffing plan for each patient care55
79+unit to provide staffing flexibility to meet patient needs; and56
80+(4) Include a contingency plan when patient care needs unexpectedly exceed direct57
81+patient care staff resources.58
82+(c) A hospital shall:59
83+(1) Use the official nurse services staffing plan:60
84+(A) As a component in setting the nurse staffing budget; and61
85+(B) To guide the hospital in assigning nurses hospital wide; and62
86+H. B. 298
87+- 3 - 25 LC 46 9002
88+(2) Make readily available to nurses on each patient care unit at the beginning of each63
89+shift the official nurse services staffing plan levels and current staffing levels for that unit64
90+and that shift.65
91+31-7-32.66
92+(a) A hospital shall establish a nurse staffing committee as a standing committee of the67
93+hospital.68
94+(b) The committee shall be composed of members who are representative of the types of69
95+nursing services provided in the hospital.70
96+(c) The chief nursing officer of the hospital shall be a voting member of the committee.71
97+(d) At least 50 percent of the members of the committee shall be registered nurses who:72
98+(1) Provide direct patient care during at least 50 percent of their work time; and73
99+(2) Represent different inpatient care units, such as, but not limited to, medical, surgical,74
100+intensive care, and cardiac units.75
101+(e) The committee shall meet at least quarterly.76
102+(f) The committee shall:77
103+(1) Develop and recommend to the hospital's governing body a nurse services staffing78
104+plan that meets the requirements of Code Section 31-7-31;79
105+(2) Review, assess, and respond to staffing concerns expressed to the committee;80
106+(3) Identify the nurse-sensitive outcome measures the committee will use to evaluate the81
107+effectiveness of the official nurse services staffing plan;82
108+(4) Evaluate, at least semiannually, the effectiveness of the official nurse services83
109+staffing plan and variations between the plan and the actual staffing; and84
110+(5) Submit to the hospital's governing body, at least semiannually, a report on nurse85
111+staffing and patient care outcomes, including the committee's evaluation of the86
112+effectiveness of the official nurse services staffing plan and aggregate variations between87
113+the nurse services staffing plan and actual staffing.88
114+H. B. 298
115+- 4 - 25 LC 46 9002
116+(g) In evaluating the effectiveness of the official nurse services staffing plan, the89
117+committee shall consider patient needs, workforce shortages and availability,90
118+nurse-sensitive outcome measures, nurse satisfaction measures collected by the hospital,91
119+and evidence based nurse staffing standards.92
120+31-7-33.93
121+(a) A hospital shall annually report to the department, and the department shall include as94
122+a confidential addendum to the annual hospital questionnaire, the following information:95
123+(1) Whether the hospital's governing body has adopted a nurse services staffing plan as96
124+required by Code Section 31-7-31;97
125+(2) Whether the hospital has established a nurse staffing committee as required by Code98
126+Section 31-7-32 that meets the membership requirements of such Code section;99
127+(3) Whether the nurse staffing committee has evaluated the hospital's official nurse100
128+services staffing plan as required by Code Section 31-7-32 and has reported the results101
129+of the evaluation to the hospital's governing body as provided by such Code section; and102
130+(4) The nurse-sensitive outcome measures the committee adopted for use in evaluating103
131+the hospital's official nurse services staffing plan and an evaluation of the effectiveness104
132+of such measures.105
133+(b) To the extent possible, the department shall collect the data required pursuant to106
134+subsection (a) of this Code section in conjunction with surveys or other data required to be107
135+submitted to the department under other laws or regulations.108
136+(c) Such information shall not be subject to Article 4 of Chapter 18 of Title 50.109
137+31-7-34.110
138+(a) The department shall maintain a secure online portal for the submission by hospital111
139+staff members of anonymous reports of unsafe staffing conditions in any hospital.112
140+H. B. 298
141+- 5 - 25 LC 46 9002
142+(b) Upon receipt of a report of unsafe staffing conditions, the department shall forward the113
143+report to its Healthcare Facility Regulation Division for investigation and to the nurse114
144+staffing committee of the hospital that is the subject of the report.115
145+(c) The Healthcare Facility Regulation Division shall investigate all reports of unsafe116
146+staffing conditions pursuant to Code Section 31-2-8. If the division determines that a117
147+patient care unit identified in a complaint did not deliver nursing services in accordance118
148+with patients' needs and generally accepted standards of practice on the date identified in119
149+the complaint or during an on-site investigation, the division shall take appropriate actions120
150+as authorized in Code Section 31-2-8.121
151+31-7-35.122
152+(a) There is hereby established an advisory commission, composed of nine members as123
153+follows:124
154+(1) The following members appointed by the Governor:125
155+(A) An expert in nursing practice, quality of nursing care, or patient care standards;126
156+(B) A representative of an association representing nurses; and127
157+(C) A representative of a hospital;128
158+(2) The following members appointed by the President of the Senate:129
159+(A) An expert in nursing practice, quality of nursing care, or patient care standards;130
160+(B) A representative of an association representing nurses; and131
161+(C) A representative of a hospital; and132
162+(3) The following members appointed by the Speaker of the House of Representatives:133
163+(A) An expert in nursing practice, quality of nursing care, or patient care standards;134
164+(B) A representative of an association representing nurses; and135
165+(C) A representative of a hospital.136
166+(b) The members of the advisory commission shall serve at the pleasure of the appointing137
167+official. Members of the advisory commission shall keep confidential any information138
168+H. B. 298
169+- 6 - 25 LC 46 9002
170+received in the course of their duties and shall only use such information in the course of139
171+carrying out their duties on the advisory commission, except those reports required to be140
172+issued by the commission under this Code section, which shall only include de-identified141
173+information.142
174+(c) The advisory commission shall convene annually in order to evaluate the effectiveness143
175+of the nurse staffing committees established pursuant to Code Section 31-7-32. Such144
176+review shall evaluate quantitative and qualitative data, including, but not limited to,145
177+whether staffing levels were improved and maintained, patient satisfaction, employee146
178+satisfaction, patient quality of care metrics, workplace safety, and any other metrics the147
179+advisory commission deems relevant.148
180+(d) The advisory commission may collect and shall be provided all relevant information149
181+necessary to carry out its functions from the department and other appropriate state150
182+agencies. The commission may also invite testimony by experts in the field and from the151
183+public. In making its recommendations pursuant to subsection (e) of this Code section, the152
184+advisory commission shall analyze relevant data, including data and factors contained in153
185+subsection (a) of Code Section 31-7-31 related to nurse services staffing plans. The154
186+advisory commission may also make recommendations for additional or enhanced155
187+enforcement mechanisms or powers to address hospital failure to comply with this article156
188+and recommend the appropriation of funds for the department to enforce this article or to157
189+assist hospitals in hiring additional staff to comply with this article.158
190+(e) The advisory commission shall submit to the Speaker of the House of Representatives,159
191+the President of the Senate, and the chairpersons of the House Committee on Health and160
192+Senate Health and Human Services Committee, and make available to the public, a report161
193+that includes recommendations for further legislative action, if any, in order to improve162
194+working conditions and quality of care in hospitals pursuant to the intent of this article.163
195+(f) Any information collected pursuant to Code Section 31-7-33 and provided to the164
196+advisory commission shall not be subject to Article 4 of Chapter 18 of Title 50."165
197+H. B. 298
198+- 7 - 25 LC 46 9002
199+SECTION 2.
200+166
201+All laws and parts of laws in conflict with this Act are repealed.167
202+H. B. 298
208203 - 8 -