ME LD1281

Establishes mandatory nurse-to-patient ratios for Maine hospitals, ambulatory surgical facilities, and freestanding emergency departments, ranging from 1:1 for ICU/critical care patients to 1:4 for medical-surgical and psychiatric units

Critical access hospitals receive a phased implementation timeline with less stringent ratios beginning July 1, 2026, tightening to match standard requirements by July 1, 2027, with a process to request temporary flexibility from the Department of Health and Human Services

Prohibits facilities from using mandatory overtime, electronic monitoring to meet staffing requirements, averaging patient counts across shifts, or laying off ancillary staff to comply with nurse staffing mandates

Protects nurses who refuse unsafe assignments or report violations, treating retaliation as a Whistleblowers' Protection Act violation with fines up to $25,000 per incident beginning July 2027

Requires facilities to maintain 3-year staffing records, post unit-by-unit staffing information publicly, and subjects violators to administrative fines up to $10,000 per day plus potential license suspension or revocation