HB0485 - Nursing Care and Quality Improvement Act

• Creates minimum direct care registered nurse-to-patient ratios for hospitals, ranging from 1:1 in operating rooms and trauma units to 6:1 (3 couplets) in postpartum units, with ratios maintained throughout each shift without averaging.

• Requires each hospital to develop and annually evaluate a staffing plan based on patient acuity systems and other factors, with input from direct care nurses or their collective bargaining representatives, to be submitted to the Director of Public Health.

• Allows nurses to refuse work assignments that would violate staffing requirements or compromise patient safety, and prohibits hospitals from discharging, discriminating against, or retaliating against nurses for such refusals.

• Prohibits hospital retaliation against any individual who reports suspected violations, participates in investigations, or discusses violations of the Act in good faith.

• Establishes civil penalties, license suspension, revocation, or conditional provisions for violations, with each staffing plan violation counted separately; directs fine revenues to nursing scholarships.