Hospital Staffing Requirements

During its 2023 session, the Washington State Legislature passed new hospital staffing regulations. The adopted law represents a compromise between hospitals and labor organizations. The new law increases regulatory oversight of hospital staffing committees while preserving the flexibility needed to maintain access to care. The new law increases accountability to hospital staffing plans, including:

  • A requirement that hospitals meet patient assignments in the hospital’s staffing plan for registered nurses, licensed practical nurses and certified nursing assistants at least 80 percent of the time or develop and follow a corrective action plan
  • Financial penalties if corrective action plans are not followed
  • Direct communication by the CEO with the staffing committee if a staffing plan proposal is rejected
  • Financial penalties for failure to follow a corrective action plan
  • Expansion of the staffing committee to include LPNs and CNAs

The new law also includes additional enforcement for missed meals and rest breaks and changes the conditions for using prescheduled on-call.

This legislative compromise was enacted in lieu of mandatory, statewide nurse-to-patient ratio requirements. WSHA’s goal, articulated by our members in negotiating the law, was to maintain access to hospital services across the state. California’s experience with statewide nurse-to-patient ratios has shown ratios to be an ineffective tool to increase the nursing workforce and would likely result in reduced access to hospital care.

The Washington State Hospital Association is committed to supporting its members in complying with both the letter and spirit of these new requirements. WSHA is offering technical assistance.

A detailed overview of the new law and its requirements for hospitals is available to members and the public in WSHA’s new law implementation guide.

Other hospital staffing implementation resources are available here.


Contact Us

Washington State Hospital Association
999 Third Avenue
Suite 1400
Seattle, WA 98104

Map / Directions

206.281.7211 phone
206.283.6122 fax

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