LOS ANGELES - Few hospitals in California have been inspected for compliance with nurse-patient ratios that went into effect in January, according to state data.
The state Department of Health Services has inspected only 28 of the 451 acute-care hospitals and found that 15 did not meet mandated staffing levels.
The agency said it does not conduct random checks to determine nurse-patient ratios but instead relies on complaints from the public and self-reporting by hospitals.
So far this year, 78 complaints have been filed, the Los Angeles Times reported Saturday.
State health officials said they do not have the authority to impose fines or close hospitals that fail to meet the requirements. However, they said they demanded a plan of compliance from the 15 hospitals that did not pass inspection.
"We consistently enforce all of the regulations that have to do with patient safety," said Sandra Shewry, the state's health director. "Any time there's an allegation and that allegation could place a patient in immediate jeopardy of health or safety, we assign a nurse or regulator to visit the facility within 48 hours."
Regular hospital inspections occur every three years. As a result, it remains unclear how many are complying with the ratios.
Jill Furillo, Southern California director of the California Nurses Association, said more enforcement was needed.
"Our feeling is the department should be more assertive," she said.
The association lobbied for the law - the first in the nation to set nurse-to-patient ratios. In an operating room, a nurse is required for each patient. No more than six patients can be under the care of a nurse in a surgical ward.
Hospital officials argued the new requirements are difficult to meet, citing the financial strain of hiring and even finding enough nurses.
Worried about the financial burden of hospitals, Gov. Arnold Schwarzenegger's administration recently proposed flexible guidelines in emergency departments during busy times. Administration officials also want to delay a part of the law which would eventually reduce the ratio from six to five patients per nurse.
The ratios have been the subject of debate since their initial passage in 1999, upheld most recently by a Sacramento County Superior Court judge in May after a challenge from a hospital organization.
Hospital administrators have complained about the cost of complying with the law and the impracticality of meeting the ratios at all times. Nursing unions strongly support the law and believe the ratios improve patient care.