ANA Legal Action On Safe Nurse Staffing
The American Nurses Association (ANA) has filed several lawsuits against various government agencies and institutions over the past couple of years to fight for safe staffing legislation.
On October 10, 2007, ANA and its state affiliate ANA/California filed a lawsuit in the Superior Court of the State of California against the California Department of Education in support of adequate RN-to-student ratios to stop the California school system from allowing unlicensed volunteer school personnel to administer insulin to students.
The ANA achieved a major victory in November 2008 by obtaining a court order to stop the unlawful use of unlicensed personnel to administer insulin. The judge’s ruling stated that the Nursing Practice Act in California is the specific statute that governs the scope of nursing practice and that the issuance of a California Department of Education directive that was contrary to that Act cannot be implemented.
Also, the American Nurses Association (ANA) and its Constituent Members Associations (CMAs) were able to shine a brighter light on the issue of RN staffing, leading to meaningful change in the accreditation process and in Medicare law that will support better RN staffing levels and improved patient outcomes.
In June 2006, ANA, the New York State Nurses Association (NYSNA) and the Washington State Nurses Association (WSNA) filed a lawsuit with the U.S. District Court for the District of Columbia to address RN staffing levels in most of the nation’s hospitals. The lawsuit focused on the U.S. Health and Human Services (HHS) Department’s failure to require The Joint Commission to apply RN staffing standards that were as high as the standards in the Conditions of Participation (COP) for the Medicare program. The COP for hospitals in the Medicare program include the requirement that there be enough staffing with RNs and other professionals so that an RN is immediately available to provide bedside care to meet patient needs, but The Joint Commission standards did not have that requirement.
While the lawsuit was pending ANA, NYSNA, and WSNA engaged in critical dialogue with The Joint Commission about needed improvements in its standards to meet every patient’s reasonable expectation that a nurse will be readily available when they need one. Beginning in July 2009, The Joint Commission’s performance elements require that each department or nursing unit must make certain that, when needed, a RN is immediately available for bedside care. The Joint Commission noted that a registered nurse is not immediately available if the RN is working on more than one unit, floor or building at the same time. Despite the fact that the court ultimately dismissed the lawsuit in January of 2009, ANA, NYSNA, and WSNA were instrumental in working with The Joint Commission in changing its standards to include these fundamental legal requirements in support of patient care.
In addition, during the summer of 2008, Congress changed the Medicare law by removing the statutory reference to The Joint Commission, effective July 15, 2010. This means that The Joint Commission will have to apply for deemed status and be approved by the federal government, just like all other accreditation programs.
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Resources
- ANA and Two State Affiliates File Lawsuit Against U.S. Dept. of HHS for Inadequate Nurse Staffing in Hospitals
- The American Nurses Association, the New York State Nurses Association, and the Washington State Nurses Association filed a lawsuit in June 2006 against the Department of Health and Human Services (HHS). The groups claim HHS allows hospitals that fail to meet federal nurse staffing requirements to participate in Medicare, thereby endangering patients. The groups also seek to prevent HHS from allowing the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) to use its own, minimal standards for nurse staffing in its accreditation of hospitals.
- The American Nurses Association, ANA/California File Lawsuit Against the California Department of Education [pdf]
- The American Nurses Association and its state affiliate ANA/California filed a lawsuit in the Superior Court of the State of California against the Superintendent of Public Instruction and the California Department of Education to remedy violations of law arising from its directive that calls on unlicensed volunteer school employees to administer insulin to students with diabetes. Specifically, the groups claim the State Department of Education is in violation of the Nursing Practice Act by permitting unlicensed school personnel to administer insulin in the absence of a true emergency.
- The American Nurses Association Advocates for Daily Availability of School Nurses for Children [pdf]
- How to Make Complaints to the Joint Commission (JCAHO) About RN Safe Staffing, When Short-Staffing Endangers Patients
- Get info on the Joint Commission on the Accreditation of Healthcare Organizations' ability to investigate safe nurse staffing issues, and JCAHO contact information.
- Second Amendment Complaint [pdf]
- ANA's Proposed Revisions to Joint Commission Standards [pdf]