MN HF2289

Establishes mandatory nurse-to-patient ratios ranging from 1:1 in operating rooms and trauma units to 1:5 in skilled nursing units, with compliance required by August 1, 2027 for most hospitals and August 1, 2029 for rural hospitals

Requires hospitals to develop staffing plans in agreement with direct-care registered nurses and obtain approval from collective bargaining units before commissioner approval; plans must be available to employees, union representatives, and the Department of Health

Mandates each hospital establish a Safe Patient Assignment Committee by October 1, 2026, with at least 60% membership consisting of nonsupervisory direct-care registered nurses who must complete annual staffing safety assessments

Prohibits hospitals from using mandatory overtime, video monitors as substitutes for direct nurse observation, or retaliating against nurses who refuse unsafe patient assignments or report staffing concerns

Imposes civil penalties of at least $25,000 per incident for noncompliance with staffing requirements, reporting failures, or persistent understaffing that increases adverse health events or workplace violence