Nurse Staffing

Summary of revised law

In 2017, the legislature passed ESHB 1714 regarding nurse staffing committee practices at hospitals. The legislation amended RCW 70.41.420 by strengthening and adding additional responsibilities for nurse staffing committees, requiring hospital staff members to submit their nurse staffing plans to the Department of Health, and establishing a complaint and investigation process. One of the department's key roles under the law is to collect hospital staffing plans. As the law requires, hospitals began submitting their nurse staffing plans to the department on January 1, 2019, and must submit them on an annual basis thereafter. Hospitals must also submit any nurse staffing plans that are updated throughout the year. The department interprets “annual basis” as 12 months from the last submitted plan. These requirements are described in detail in RCW 70.41.420 through 70.41.425.

Nurse staffing report

House Bill 1714 directed the department to submit a Nurse Staffing Report (PDF) to the legislature by December 31, 2020, that addresses the number of nurse staffing complaints received, the status of those complaints, the number of investigations conducted, the costs associated with the complaint investigations, projections for the effect on hospital fees over the next four years, and recommendations for any needed statutory changes. The recommendations for statutory changes were developed jointly by the department, the hospital and nursing associations, and the two labor unions.

How to submit nurse staffing plans

Submit hospital nurse staffing plans as a PDF attachment to this email.

Department guidance for submitting nurse staffing plans:

  • Hospitals should include their facility name, the date of the plan, and indicate if the plan being submitted is a “Partial Update” or “Comprehensive Update.”
  • Staffing plans developed for various hospital units should be compiled into a single comprehensive nurse staffing plan and converted into a single PDF file. Please no WORD or Excel files – only a single PDF.
  • If hospitals update staffing plans for one or more units throughout the year, please insert the updated unit plans into the overall comprehensive plan and submit to DOH as a single PDF (these should be labeled “Partial Update”)
  • When developing your plans, please make formatting, language, and labeling choices that best assists hospital staff as well as the public in understanding the details.
  • After submitting your plan, check the Hospital Policies webpage in about two week to verify your plan has been posted. Contact us by an email if your plan hasn't been posted or there are errors needing correction.

See previously submitted policies on the Hospital Policies webpage. Select the specific hospital(s).

To sign up for ongoing updates regarding nurse staffing, subscribe for updates at the bottom of the page.

Resources to assist with compliance

In an effort to support implementation and to ensure success under the law, the Washington State Hospital Association, Washington State Nurses Association (WSNA), Service Employees International Union (SEIU) Healthcare 1199NW, and United Food and Commercial Workers (UFCW) 21 came together in 2018 to form The Nurse Staffing Coalition. Over the past year, the coalition has developed guidance documents for hospitals to use to meet the law's requirements. The guidance documents include:

  • Nurse Staffing Committee Checklist: Includes key elements of nurse staffing committees, including composition, primary responsibilities, staffing plan development, and implementation of the plan.
  • Sample Nurse Staffing Committee Charter
  • Nurse Staffing Plan Minimum Criteria: Core elements of the nurse staffing plan (matrix by unit and shift) recommended for submission to Department of Health.
  • Sample Attestation Form: Signed by the hospital CEO attesting that the nurse staffing plan submitted to the Department of Health was developed in accordance with the law.
  • Staffing Complaint Form: Used to submit complaints to nurse staffing committees and to document nurse staffing committee responses to complaints.
  • Assessing and Evaluating Complaints: Tool to help nurse staffing committees assess and evaluate complaints, including a decision tree outlining the process.
  • Complaint Tracking Tool: Form to help nurse staffing committees track complaints, the resolution, and the timeframes in which complaints were received and resolved.

The guidance documents are on coalition members' websites, linked below on the organization name. We encourage you to contact members of the Nurse Staffing Coalition for more information.

Trish Anderson
Senior Director of Safety and Quality

Anne Tan Piazza
Senior Director of Strategic Initiatives
206-575-7979, ext. 3006

SEIU Healthcare 1199 NW
Jane Hopkins
Executive Vice President

Samantha Grad
Political and Legislative Organizer

How to submit a nurse staffing complaint

RCW 70.41.425 allows DOH to investigate only complaints that relate to one or more of the following:

  • The hospital did not form or establish a staffing committee.
  • The hospital did not conduct a semiannual review of a nurse staffing plan.
  • The hospital did not submit a nurse staffing plan in the previous 12 months or did not submit any updated plan it developed throughout the year.
  • The hospital did not follow the nursing personnel assignments in a patient care unit or shift-to-shift adjustments in staffing levels.

If you are submitting a complaint, make sure you include documented evidence that supports your allegation. Complaints submitted without supporting evidence or data will be closed with the reason code of “insufficient information.” The complainant will be notified that the complaint has been closed, and will have the option to submit follow-up data for reconsideration.

You may submit your nurse staffing complaint by using the department's standard healthcare facilities complaint process.

If the department determines that a nurse staffing complaint warrants an investigation, it will use the following investigative process (PDF).