HB3871 - Safe Patient Limits Act

• Creates maximum nurse-to-patient ratios for registered nurses across various hospital units, ranging from 1:1 for critical care and operating room patients to 4:1 for medical/surgical patients.

• Establishes specific staffing requirements by unit type including critical care (2:1), postanesthesia care (1:1 for pediatric, 2:1 for adults), emergency department (3:1 general, 2:1 critical care, 1:1 trauma), and maternal child care (1:1 active labor, 1 couplet for immediate postpartum).

• Prohibits averaging patient counts across staff, video monitoring as substitute for direct observation, and mandates facilities maintain staffing levels without diminishing overall health care workforce numbers.

• Requires facilities adopt written training and orientation policies ensuring nurses demonstrate competence before assignment to units, with temporary staff receiving equivalent training as permanent staff.

• Grants registered nurses rights to refuse unsafe assignments, prohibits retaliation for refusing assignments or reporting violations, and establishes civil penalties up to $25,000 per day for non-compliance; suspends enforcement during declared public health emergencies.