ESHB 1714

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

C 249 L 17

Synopsis as Enacted

Brief Description: Concerning nursing staffing practices at hospitals.

Sponsors: House Committee on Health Care & Wellness (originally sponsored by Representatives Cody, Doglio, Ryu, Pollet, Peterson, McBride, Wylie, Stonier, Goodman, Sawyer, Bergquist, Gregerson, Sullivan, Lytton, Tharinger, Chapman, Lovick, Senn, Hansen, Sells, Frame, Fitzgibbon, Riccelli, Macri, Jinkins, Dolan, Stanford, Orwall, Ortiz-Self, Farrell, Slatter, Tarleton, Clibborn, Fey, Kilduff, Reeves, Pettigrew, Appleton, Robinson, Blake, Ormsby, Pellicciotti, Kloba, Hudgins and Santos).

House Committee on Health Care & Wellness

House Committee on Appropriations

Senate Committee on Health Care

Senate Committee on Ways & Means


Hospitals must establish nurse staffing committees to develop and oversee an annual patient care unit and shift-based nurse staffing plan; conduct a semiannual review of the nurse staffing plan; and review, assess, and respond to staffing concerns. Hospital finances may be taken into account in the development of a nurse staffing plan. A nurse staffing plan must consider such factors as:

If the chief executive officer of the hospital does not approve the nurse staffing committee's plan, he or she must provide a written explanation to the committee. The hospital may not retaliate against employees performing duties in connection with the nurse staffing committee or an individual who notifies the nurse staffing committee or the hospital administration about concerns on nurse staffing.


The duties of a nurse staffing committee are expanded to include the review, assessment, and response to staffing variations. The factors that must be considered in developing a nurse staffing plan are expanded to include:

If a hospital does not adopt a nurse staffing committee's staffing plan, the chief executive officer of the hospital must either identify the elements of the plan being changed prior to adoption or prepare an alternative plan that must be adopted by the hospital. Beginning January 1, 2019, a hospital must implement its nurse staffing plan and assign nursing personnel to patient care units according to the plan. The hospital must submit its adopted nurse staffing plans to the Department of Health (DOH) annually and whenever the plan is updated.

A registered nurse may report to the staffing committee any variations where the nurse personnel assignment in a patient care unit is not in accord with the adopted staffing plan and may make a complaint to the committee based on the variations. Shift-to-shift adjustments in staffing levels required by the plan may be made by the appropriate hospital personnel overseeing patient care operations. If a registered nurse on a patient care unit objects to a shift-to-shift adjustment, the nurse may submit the complaint to the committee. The committee must develop a process to examine and respond to these data, including the ability to determine if a specific complaint is resolved or dismiss a complaint based on unsubstantiated data.

The DOH must investigate a complaint for a violation of nurse staffing committee or nurse staffing plan requirements if the complaint has documented evidence of failure to:

The DOH may only investigate complaints relating to personnel assignments or shift-to-shift adjustments after making an assessment that the submitted evidence indicates a continuing pattern of unresolved violations that were submitted to the nurse staffing committee, excluding complaints determined to be resolved or dismissed. The evidence must include the aggregate data contained in the complaints submitted to the nurse staffing committee indicating a continuing pattern of unresolved violations for a minimum 60-day continuous period leading up to the DOH's receipt of the complaint.

The DOH may not investigate complaints relating to personnel assignments or shift-to-shift adjustments in the event of unforeseeable emergency circumstances or if the hospital, after consultation with the nurse staffing committee, documents it has made reasonable efforts to obtain staffing to meet required assignments, but has been unable to do so. "Unforeseeable emergency circumstance" is defined as:

If the DOH finds there has been a violation, the hospital must submit a corrective plan of action to the DOH within 45 days of the presentation of findings to the hospital. Failure to submit or to follow a corrective plan of action may result in fines of $100 per day for all violations asserted against the hospital at any time until the hospital submits or begins to follow a corrective plan of action or takes other action agreed to by the DOH. The DOH must maintain for public inspection records of any civil penalties, administrative actions, or license suspensions or revocations imposed on hospitals for these purposes.

The complaint process does not preclude the ability to otherwise submit complaints regarding nurse staffing to the DOH.

The DOH must submit a report to the Legislature on December 31, 2020, which must include the number of complaints submitted to the DOH, the disposition of the complaints, the number of investigations conducted, the associated costs for complaint investigations, recommendations for needed statutory changes, and projections on the impact on hospital licensing fees over the next four years. The DOH must convene a stakeholder group prior to submitting the report to review the report and findings and to jointly develop any legislative recommendations. The group must consist of the Washington State Hospital Association, the Washington State Nurses Association, Service Employees International Union Healthcare 1199NW, and United Food and Commercial Workers 21.

The DOH may not increase fees to implement the act prior to July 1, 2021.

The act expires on June 1, 2023.

Votes on Final Passage:








(Senate amended)

(House refused to concur)




(Senate receded/amended)




(House concurred)


July 23, 2017