Though the hospital industry has insisted it was all but financially impossible to meet the state's strict nurse-to-patient ratios, a number of hospitals have been able to do it without breaking their budgets.
About 36% of the hospitals inspected by the state's Department of Health Services passed their surveys, according to a Times review of state data from the first 10 months of last year.
That's more than the 15% compliance rate that the California Healthcare Assn. has estimated based on its survey of 300 institutions.
The findings come as the Schwarzenegger administration and major hospitals are trying to scale back the ratios in California, which was the first state in the nation to limit the number of patients a nurse can treat.
Though most of the hospitals inspected by the state did not meet the ratio standards, those that did offer a lesson in balancing the financial burden of hiring more nurses with the benefits of complying with the law.
The hospitals that have been able to meet the ratios vary in size and location, from a 70-bed public facility in Banning to a 540-bed medical center run by UC San Diego.
But they tend to have several things in common:
* Many have been able to make up the costs of more nurses by renegotiating rates with private insurance companies or persuading insurers to send more patients their way.
* Most are in relatively good fiscal health, with a median net income of about $10 million for 2003. Only two facilities reported losses for 2003.
* Officials at some hospitals say they have less trouble recruiting than other medical centers because their facilities have nationally known specialties and they work hard to keep their nurses happy. Their rates for turnover and job vacancy are lower than state averages, which both hover around 15%.
The hospitals also tend to have low rates of using temporary nurses. Many have the added perk of being in attractive locations: pretty seaside towns, for instance, or areas with affordable housing.
The numbers of patients that nurses are allowed to handle are based on the severity of patients' illnesses. In an operating room, for example, each patient is required to have a nurse. In a medical-surgical ward, one nurse can care for six patients.
