How Oregon’s Hospital Staffing Law is failing our communities
At Asante, our top priority is to provide quality health care services in a compassionate manner valued by the communities we serve. As the leader in providing critical care and services to southern Oregon, we unequivocally support safe staffing, both philosophically and in practice. While HB 2697 (2023) set forth a framework for hospital staffing supported by a coalition of stakeholders, the implementation of that framework has failed the shared vision. Now, common-sense amendments are urgently needed to prevent this law from harming access for patients and damaging health care throughout Oregon.
The implementation of the new hospital staffing law has been tone-deaf to current realities in Oregon and over-reaching in its interpretation. It emphasizes complex procedural requirements that place disproportionate burdens on hospitals, without offering any clear benefit to patients. The result is daily fines for community hospitals—in Rogue Regional Medical Center’s case, at least $5,000 in penalties every single day—which is diverted out of our community and towards the Oregon Health Authority (OHA).
Oregon needs to chart a different course now. Asante is calling on Oregon’s legislature for common-sense amendments to the law that will support safe staffing, advance patient safety, and preserve health care resources and access.
History of the hospital staffing law
Asante has operated in alignment with Oregon’s hospital staffing law since the first version was first enacted in 2002. Originally, the law was built on two concepts: patient acuity and shared governance. Hospitals and their staffing committees would collaborate on hospital staffing plans, using patient acuity as their guide. For over two decades, this collaborative model worked, with OHA providing enforcement through regular surveys and corrective action plans.
Then, the COVID-19 pandemic hit. A confluence of global, once in a lifetime forces converged on front line health care workers and hospitals. Extreme, extended demand; burn-out; labor shortages and inflation.
The coalition’s intentions for HB 2697
In response to these challenges, a coalition of labor unions and health care leaders sought a new path forward through House Bill 2697, enacted in 2023 and gradually implemented since then.
The intention of the coalition was to create a simpler framework, based around nurse-to-patient ratios. The ratios would apply to the different units of the hospital unless the staffing committees decided to implement a different staffing plan, such as a new innovative care model.
Asante continues to support the coalition’s intention to implement ratios as a simple, effective means of staffing units.
OHA’s disastrous implementation of HB 2697
What was originally intended as a collaborative framework with ratios as the backstop (unless the committees decided to try something different), has devolved into a punitive regulatory morass.
Rather than applying the ratios as the standard default plan, OHA instead interprets the law to give each hospital’s staffing committee ultimate power to enact staffing plans. And if the committee fails—or refuses—to agree to a staffing plan, it’s the hospital who is penalized, not the labor union and its representatives.
The problem is that the staffing committees operate independently and can withhold their approval indefinitely and without cause. To make matters worse, the law deprives the hospital of any recourse if its committee refuses to play ball.
So, if the committee fails to adopt a plan, either because it proposes a plan that the hospital cannot operationally support or because it proposes a plan that does not align with statutory intent, it is the hospital that is penalized and fined. The hospital is put into a position of either accepting unreasonable demands not contemplated by the law, or taking these daily penalties.
Penalties for technicalities, not patient safety
The results have been staggering. Over a three-month period in 2025, OHA has penalized Rogue Regional, just one single hospital in a state with over 50, over $450,000 in penalties for “failure to have a nurse staffing plan,” which has nothing to do with legislated safe staffing ratios.
That figure stands in stark contrast to the amount OHA has fined Rogue Regional for things actually associated with meeting safe nurse staffing: $4,500.
So, what can be done about this? What are the suggested solutions? Stay tuned for part two of this blog series, appearing tomorrow on AsanteIMPACT.
