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A Controversial Nurse to Patient Ratios Law

Imagine you’ve made the difficult decision to place a loved one in a nursing home or long term care facility. We all want the best care for our relatives, but will your family member receive it? The sad reality is that nursing homes are generally understaffed which directly affects patient care. California lawmakers are trying to do something about this.

California Nurse to Patient Ratios Law

Nurse to Patient Ratios Law


Currently California skilled nursing facilities, nursing homes, long term care or any facility that receives Medi-Cal, Medicare or is licensed in California must provide 3.2 nursing hours per patient per day. What that actually means is that each patient must receive direct care from a nurse or nursing assistant for a minimum of 3.2 hours every day.

How do they calculate this? Add the total number of nurses and nursing assistants on duty per day. Divide the total nursing hours by the total number of patients in the facility. For example: 3 nurses each work 12 hours in a facility that has 30 patients – 3×12 = 36 divided by 30 = 1.2 nurse staffing hours per patient day.

Long term care facilities in California will encounter penalties in the form of fines if they do not comply with nurse to patient ratios required by the state. The new law increases the number of facility auditors and is designed to reinforce the Long Term Care Reimbursement Act of 2004.

The whole purpose, according to the Legislature when they passed it, was to increase staffing and create a better quality of care – and of course, the key is staffing. One of the changes will be to restore funds ($1.9 million) to the Long Term Ombudsman Program, in which a $3.8 million cut was initiated two years ago.
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