HB 4279 Summary

• Requires hospitals to provide sufficient qualified registered professional nurses at all times to ensure patient safety and develop staffing plans within 3 years (4 years for rural hospitals).

• Establishes mandatory minimum nurse-to-patient ratios for hospital units including intensive/critical care (1:1), operating room (1:1 plus scrub assistant), labor and delivery (1:1 to 1:4 depending on stage), emergency department (1:1 to 1:3 depending on acuity), and other units ranging from 1:3 to 1:6.

• Requires hospitals to establish staffing committees for each unit with at least half the members being registered nurses providing direct care; committees must be consulted before decreasing ratios and nurse participation counts as paid work time.

• Prohibits hospitals from averaging staffing ratios across shifts, using unqualified nurses to meet ratios, or imposing mandatory overtime except in unforeseen emergencies to meet minimum staffing requirements.

• Establishes enforcement through department investigation of complaints, corrective action plans, and administrative fines ranging from $10,000-$25,000 per violation (or $25,000-$50,000 for pattern violations), with fines published on the department website and considered in licensure decisions.