IL HB3338

Creates the Safe Patient Limits Act establishing maximum patient-to-nurse ratios for registered nurses across various hospital units, including 1:1 for critical care, 1:1 for active labor, 1:3 for step-down care, and 1:4 for medical/surgical patients.

Prohibits facilities from laying off support staff to meet the new patient limits and requires no averaging of patient assignments across multiple nurses; mandates at least two direct care registered nurses present in each unit at all times.

Requires all facilities to adopt written policies for nursing staff education, training, and orientation to each clinical area, with no nurse assigned to a unit without demonstrated competence in that area.

Establishes nurse protections including rights to refuse unsafe assignments, prohibits retaliation for objecting to violations, and prevents facilities from filing complaints with the Board of Nursing based on refusal to complete assignments.

Requires facilities to submit quarterly staffing records to the Department of Public Health, imposes civil penalties up to $25,000 per violation for non-compliance, and allows the Department to conduct periodic audits for enforcement.