CA SB227

Requires periodic inspections of general acute care hospitals, acute psychiatric hospitals, and special hospitals to include reviews of compliance with nurse-to-patient ratios and staff assignment regulations, conducted without advance notice.

Establishes administrative penalties of $15,000 for the first violation and $30,000 for each subsequent violation of nurse-to-patient ratio and staff assignment regulations.

Exempts general acute care hospitals from penalties if they demonstrate that staffing fluctuations were unpredictable, prompt efforts were made to maintain required levels, and the hospital exhausted its on-call nurse list and charge nurse resources.

Allows hospitals to request a hearing within 10 working days to dispute penalty determinations, with penalties due only after all appeals are exhausted and the department's position is upheld.