Oregon’s Hospital Staffing Law has enjoyed no lack of coverage (and commentary) in the last year. The Oregon Health Authority (OHA) has posted numerous guidance documents, FAQs, video shorts, and recorded webinars to bring us all along on the implementation and enforcement journey. The vast majority of covered entities in Oregon have filed staffing plans, but as enforcement efforts ramp up, so do questions around compliance.
One of the key points of the staffing requirements is that hospital staffing plans must contemplate and address all licensed hospital space – this means on-campus, off-campus, in-patient, and out-patient space. And, to be clear, this broad “hospital-license-wide” application is despite any definitional language that might lead to other conclusions.
OHA Clarifies Nurse Staffing Coverage
While OHA has commented on this “license-based” application of the staffing laws in the last year in the context of professional/technical and service staffing, the OHA’s latest video short, dated August 6, 2025, provides official, direct guidance on this topic as to nurse staffing. In the first minute of the guidance video, Jacqueline Felix, Compliance Specialist with OHA, explains that Oregon’s nurse staffing laws cover essential RNs, LPNs, and CNAs who are primarily providing direct patient care. As to the location where that nursing care occurs, Ms. Felix states, “This includes care provided in the main hospital building, in spaces operating under the hospital’s license on the hospital campus, and at any off-campus clinics operating under the hospital license. This can include both inpatient and outpatient services.”
Though ORS 441.766 clearly directs that outpatient departments falling under the hospital license must adopt a nurse staffing plan, this new guidance closes a gap between potential interpretations of the ORS and OAR definitions of a “hospital” facility or location subject to the staffing law’s requirements as a preliminary matter.
Guidance for Staffing Committees
Hospitals and staffing committees should ensure that their staffing plans contemplate staffing levels at all locations under the hospital license, including outpatient departments and off-campus locations. Space that is separately licensed – for example, as an ASC or out-patient hospice – is not subject to the staffing requirements.
Limits of Enforcement
As hospital staffing committees are updating or amending plans, keep in mind OHA can only enforce the mandatory and required staffing levels as stated in a hospital’s staffing plan – there is no enforcement authority for plan language that contemplates permissive or ideal staffing levels, or other recommendations of the committee. The staffing laws do not prescribe ratios for professional/technical and services staffing, and statutorily prescribed ratios for registered nurses do not apply to outpatient departments.
