Hospital Staffing

Laws, rules and administration of hospital staffing in Oregon

On this page:

• Hospital Staffing Information 
  
• Administrative Rules
  
• Hospital Staffing Laws
• Health Care Regulation and Quality Improvement Section (HCRQI) & Health Facility Licensing and Certification Program (HFLC)
• Nurse Staffing Advisory Board (NSAB)
  
• Variances and Waivers
  
• Hospital Staffing Complaint Process
  
• Hospital Staffing Plan Submission & Posting
  

Hospital Staffing Information

OHA is creating a variety of resources to provide information and answer questions about hospital staffing laws following the passage of HB 2697. OHA will use the hospital staffing listservs to announce new resources as they become available.

• OHA presented a brief overview (pdf) of key aspects of the bill at the Nurse Staffing Advisory Board meeting on July 26, 2023. 
• House Bill (HB) 2697 Hospital Staffing Law Frequently Asked Questions (FAQ) (pdf) (updated September 9, 2024)
  

Updated November 4, 2024

Administrative Rules

OHA has issued permanent administrative rules, effective May 15, 2024, to implement House Bill 2697, now codified under Oregon Revised Statues 441.760 - 441.795. Additional information on the rulemaking activity and the Rulemaking Advisory Committee can be found under Rulemaking Advisory Committees In Progress at www.healthoregon.org/hcrqirules.

Oregon Administrative Rules Chapter 333, Division 503, Hospital Staffing, includes:

• OAR 333-503-0002, Applicability
  
• OAR 333-503-0005, Definitions
  
• OAR 333-503-0010, Filing Hospital Staffing Complaints
  
• OAR 333-503-0020, Processing Complaints
  
• OAR 333-503-0040, Hospital Staffing Enforcement
  
• OAR 333-503-0050, Hospital Staffing Plan Waiver
  
• OAR 333-503-0060, Nursing Staff Member Overtime
  

Hospital staffing laws

Oregon's nurse staffing laws are found in

HCRQI and HFLC

Health Care Regulation and Quality Improvement (HCRQI)

HCRQI oversees the implementation of hospital 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 program is responsible for hospital staffing complaint investigations pursuant to Oregon statutes. HFLC staff work together to provide guidance to hospitals and hospital staff members throughout Oregon. HFLC also maintains a list of hospital staffing committee co-chairs and chief nursing officers. Hospitals should submit a change form if the hospital 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. OHA will be creating listservs for professional/technical staffing and services staffing shortly.

Select Join our Listserv to get started.

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)
• 2023 Legislative Report (pdf)
  

NSAB Meeting Schedule

Variances and Waivers

Nurse Staffing Variances

Under ORS 441.763(6), a hospital may vary from requirements related to staffing ratios for direct care registered nurses if:

• The hospital is a Type A or Type B hospital;
• The requirement being varied is in ORS 441.765;
• The nurse staffing committee has voted to approved the variance; and
• The Co-Chairs of the nurse staffing committee submit a signed statement to OHA that the nurse staffing committee voted to approve the variance.
  

HFLC may waive one or more of the staffing plan requirements 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 Hospital Staffing Waiver Request Form (pdf) to prepare the written request.

Hospital Staffing Complaint Process

HFLC staff will be developing new tools for hospital staffing complaint investigations to align with the bases for noncompliance citations specified in Oregon Revised Statute 441.792. 

• OHA surveyors review complaints sent to the OHA and seek any additional information they need. Once surveyors have a completed complaint intake, OHA
  
• Provides a copy of the complaint to the staff member's Exclusive Representative
• Notifies the hospital, staffing committee co-chairs, and Exclusive Representative of the pending complaint;
• Receives documentation regarding the allegations from the hospital; and
• Conducts an investigation within 80 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, the staffing committee co-chairs, and the Exclusive Representative a written report that explains any hospital staffing concerns found during the investigation. OHA will be able to assess civil monetary penalties for violations that occur on or after June 1, 2025; and
• OHA maintains and posts complaint reports online (see below).

Hospital Staffing Plan Submission & Posting

Oregon's hospital staffing law requires hospitals to submit Nurse Staffing Plans, Professional/Technical Staffing Plans, and Services Staffing Plans to OHA within 30 days of approval by the staffing committee.

Hospitals may submit their approved plans through OHA's online Hospital Staffing Plan Submission Form.

NOTE: OHA is currently receiving a high volume of staffing plan submissions. Submitted staffing plans will be posted to this page within five business days of receipt.

Under ORS 441.766(3), a hospital Nurse Staffing Committee may submit certain Nurse Staffing Plans to OHA for arbitration if a plan is not adopted after a 60-day deliberation period. Click here to submit your request for a list of arbitrators.

View Reports from Nurse Staffing Surveys and Hospital Staffing Complaint Investigations

Listed below are reports generated from nurse staffing surveys and hospital staffing 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