SB 334 Summary

• Establishes mandatory minimum registered nurse-to-patient ratios for Michigan hospitals across 11 unit types, ranging from 1:1 ratios in intensive care and operating rooms to 1:4 ratios in medical/surgical and behavioral health units

• Requires hospitals to comply within 1 year (2 years for rural hospitals) and maintain ratios at all times including during breaks and meal periods, with exceptions only during declared states of emergency

• Prohibits hospitals from averaging patient assignments, including non-qualified nurses in ratio calculations, or imposing mandatory overtime to meet staffing requirements (except during declared emergencies)

• Establishes enforcement through department complaint investigation, corrective action plans, and administrative fines of $10,000-$25,000 per violation or $25,000-$50,000 for pattern violations, with violating hospitals published on the department website

• Creates a nurse-to-patient ratio regulatory fund to be administered by the department, funded by collected administrative fines and used solely for implementing and enforcing the staffing requirements