New safe staffing law requirements started July 1

Beginning July 1, 2025, Washington state hospitals must follow new nurse staffing requirements.

• All hospitals must implement and assign nursing staff in accordance with their 2025 hospital staffing plan. See hospital staffing plans.
• Hospitals (*not exempt from the new law) document and report to the Washington Department of Health (DOH) when the number of patients assigned to nursing staff exceeds the nurse staffing plan at any time during the shift.
  • Nonexempt hospitals submit a non-compliance report when nurse staffing assignments comply with the staffing plan less than 80 percent during the month.  
  • Hospitals submit a non-compliance report to the WA DOH within seven calendar days following the month that the facility is out of compliance.
• Hospitals publicly post the hospital staffing plan (and any corrective action plans) in each department/unit.  
• Hospitals adopt written policies/procedures for the orientation of direct care RNs and NA-Cs, sufficient to provide competent patient care, before assignment to a nursing unit or clinical care area.

*Exempt hospitals: critical access, hospitals with fewer than 25 acute care licensed beds, sole community hospitals not owned/operated by a health system, and hospitals located on an island in Skagit County. See question 13 for full list of exempt hospitals.

My hospital uses “break buddies” to provide meal/rest break relief. I regularly care for twice as many assigned patients when my co-workers are gone for their meal or rest periods. Is this OK?

Hospitals must maintain compliance with their staffing plan throughout the shift. If the number of patients assigned to nursing staff exceeds the patient care unit assignment (as directed by the nurse staffing plan), then use of break buddies is not permissible, and the unit/department is out of compliance.

Action: File an ADO if meal/rest break relief in your unit/department results in an increase in the number of patients assigned to the nursing staff that exceeds the patient care unit assignment as directed by the nurse staffing plan.

Our hospital’s policy says that compliance with the nurse staffing plan is evaluated twice per day, once at the beginning of each 12-hour shift (on my medical/surgical unit). Is it true that if staffing levels at the beginning of the shift comply with the staffing plan, then the hospital doesn’t need to assess staffing plan compliance for the rest of the shift?

Hospitals must maintain compliance with their staffing plan throughout the shift and must document each time staffing is out of compliance with the staffing plan. Per RCW 70.41.420(7)(b), “compliance means the number of patients assigned to the nursing staff exceeds the patient care unit assignment as directed by the nurse staffing plan.”

Action: File an ADO if at any time during the shift, the number of patients assigned to the nursing staff exceeds the patient care unit assignment as directed by the nurse staffing plan.