Bill
SB 5271
Creates a uniform enforcement framework for DOH facilities and pharmacies, enabling standardized penalties, license conditions, and service suspensions to protect patients.
Status / key dates
- Enacted as Engrossed Substitute Senate Bill 5271 (68th Legislature, 2024 Regular Session).
- Passed Senate 1/24/2024; passed House 2/29/2024.
- Governor signed 3/15/2024. Effective date: 6/6/2024.
- Sponsored by the Senate Committee on Health & Long Term Care (original sponsors: Senators Cleveland, Robinson, Kuderer, Nobles, Wellman, and C. Wilson); requested by the Department of Health (DOH).
Purpose / intent
- To create a single, consistent enforcement framework that strengthens and standardizes the Department of Health’s enforcement authority across the different types of health care facilities it licenses and to extend comparable enforcement tools to pharmacies and licensees governed by the Pharmacy Quality Assurance Commission. The bill’s stated goal is to better protect patients by making enforcement tools uniform, predictable, and available where patient safety is at risk.
What the bill does — key provisions
- Establishes a uniform definition of “immediate jeopardy”: noncompliance that places patient health or safety at risk of serious injury, serious harm, serious impairment, or death.
- Expands and standardizes DOH enforcement options across many facility types (in addition to the acute care and psychiatric hospital authorities enacted in prior years). Covered facility types called out in the bill include:
- Acute care hospitals and psychiatric/private/behavioral health hospitals and private establishments;
- Birthing centers;
- In‑home services agencies (home health, hospice, home care);
- Ambulatory surgical facilities;
- Behavioral health agencies (licensed or certified);
- Medical test sites.
- Permits the DOH, when it finds prior similar enforcement actions, outstanding deficiency statements, or failure to correct noncompliance by an agreed date, to:
- Impose reasonable license conditions (e.g., required corrections, staff training, or use of a DOH‑approved consultant);
- Assess civil fines (amounts vary by facility type — see below).
- Creates graduated remedies that depend on the severity and persistence of violations, including (as applicable):
- Imposition of license conditions to enforce corrections;
- Civil monetary penalties;
- Limited “stop service” (suspending specific categories of services or units);
- Limited “stop placement” (suspending admissions of particular patient categories);
- Full “stop placement” (suspending new admissions across a facility when immediate jeopardy is not limited to a particular service or patient category);
- Suspension, revocation, or refusal to renew a license.
- Extends a comparable enforcement framework for pharmacies and Pharmacy Quality Assurance Commission licensees (unifying enforcement posture between DOH‑licensed facilities and pharmacy licensing/discipline).
- Revises certain statutory definitions (e.g., renames or clarifies references to “psychiatric hospitals” as “private establishments” or “behavioral health hospitals” in some contexts).
- Amends, reenacts, and adds numerous sections across Washington law (multiple RCW chapters), and repeals some obsolete provisions; prescribes penalties consistent with the new framework.
Civil penalty amounts (representative amounts set in the bill)
- Acute care hospitals and psychiatric hospitals (prior legislation already provided): up to $10,000 per violation; cumulative maximum total fines of up to $1,000,000 in specified circumstances. Also up to $10,000 per day for operating a psychiatric hospital without a valid license.
- For other DOH‑regulated facilities under the new uniform framework:
- Birthing centers, in‑home services agencies, behavioral health agencies: up to $3,000 per violation.
- Ambulatory surgical facilities: up to $7,500 per violation.
- Private establishments (behavioral health hospitals, certain hospitals, residential treatment facilities): up to $10,000 per violation.
(Note: dollar amounts are statutory caps—actual penalties depend on DOH findings, prior history, and statutory procedures.)
Who is affected
- Patients and residents of DOH‑regulated facilities (greater statutory protection intended).
- All licensees regulated by the Department of Health within the listed facility types.
- Pharmacies, pharmacists, and other entities/individuals regulated by the Pharmacy Quality Assurance Commission.
- The Department of Health and the Pharmacy Quality Assurance Commission (expanded/standardized enforcement responsibilities and authorities).
- Facility operators and owners — greater risk of fines, licensing conditions, service/admission suspensions, and license actions when noncompliance is found.
Procedural and operational notes
- The bill builds on earlier, facility‑specific enforcement statutes adopted in 2020–2021 (for psychiatric and acute care hospitals) by extending similar tools across additional facility types and to pharmacy regulation.
- Stronger measures (e.g., stop service/placement) are tied to the statutory “immediate jeopardy” standard; prior enforcement history or failure to timely correct deficiencies increases the likelihood of higher fines or additional conditions.
- The enactment amended many RCW sections and added new statutory sections to implement the unified framework; the law took effect 6/6/2024.
Implications / likely impact
- Provides DOH and the Pharmacy Quality Assurance Commission clearer, consistent statutory bases to use graduated enforcement tools to protect patient safety.
- Standardizes penalties and nonmonetary enforcement options across facility types, which may improve regulatory predictability for both regulators and licensees.
- Could increase compliance activity and corrective actions by facilities and pharmacies to avoid fines and service/admission suspensions.
- Facilities with repeated or uncorrected deficiencies face steeper civil penalties and more immediate corrective orders when patient safety is threatened.
For readers seeking more detail
- The enacted bill amends and adds statutory language across numerous RCWs (see bill text for specific amendments and new sections). The bill was requested by the Department of Health and is recorded as Engrossed Substitute Senate Bill 5271 (68th Legislature, 2024).
Compiled from official sources — confirm details with the bill’s official record.
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