MI HB4550

Establishes minimum nurse-to-patient ratios for Michigan hospitals, requiring compliance within 1 year (2 years for rural hospitals) across multiple unit types including intensive care (1:1), operating rooms (1:1), labor and delivery (varying from 1:2 to 1:4), emergency departments (1:3 non-critical, 1:1 critical), and medical/surgical units (1:4).

Prohibits hospitals from averaging ratios across shifts, including unqualified nurses in ratio calculations, or imposing mandatory overtime to meet minimums except during declared states of emergency unrelated to labor disputes or chronic understaffing.

Requires hospitals to post notices of nurse-to-patient ratio requirements in visible locations and provide patients with a department toll-free number to file complaints, with the department investigating alleged violations.

Imposes administrative fines of $10,000-$25,000 per violation ($25,000-$50,000 for pattern violations), requires corrective action plans, and mandates public posting of hospitals receiving fines on the department website.

Creates a nurse-to-patient ratio regulatory fund to receive administrative fines, which the department shall use only for administering the nurse-to-patient ratio requirements.