FL S0644

Establishes mandatory nurse-to-patient ratios in Florida hospitals, ranging from 1:1 for trauma and operating rooms to 1:6 for well-baby nurseries, with specific ratios for each type of hospital unit including critical care (1:2), emergency rooms (1:3), and surgical units (1:4)

Prohibits hospitals from imposing mandatory overtime on nurses to meet staffing requirements and bars the use of acuity-adjustable units or video monitors as substitutes for direct nurse observation

Requires each health care facility to develop and annually update a written staffing plan using an acuity-based patient classification system, with documentation submitted to the Agency for Health Care Administration

Grants nurses the right to refuse patient assignments if they lack competence for the specific care required or if the assignment would violate nursing practice standards, with protections against employer retaliation for such refusals

Authorizes civil penalties of up to $25,000 per violation against health care facilities and up to $20,000 against individual employees who violate the staffing requirements, with the Agency for Health Care Administration required to establish a toll-free hotline for reporting violations