OH HB629

Establishes mandatory direct-care registered nurse-to-patient staffing ratios in Ohio hospitals, with specific ratios for different unit types ranging from 1:1 (operating rooms, critical care) to 1:5 (rehabilitation and skilled nursing units).

Requires hospitals to create hospital-wide nursing care committees with at least 50% direct-care registered nurse membership to develop and recommend nursing services staffing plans based on patient acuity, complexity of care, and evidence-based standards.

Prohibits hospitals from imposing mandatory overtime on nurses to meet staffing ratios, using video monitoring as substitute for direct patient observation, averaging staffing numbers, or retaliating against nurses who refuse unsafe assignments.

Grants registered nurses the right to advocate for patients, refuse assignments they are not competent to perform, and object to practices violating the staffing ratio requirements without fear of discharge, retaliation, or disciplinary complaints to the board of nursing.

Imposes fines of up to $25,000 plus $10,000 per shift for hospital non-compliance, and allows individual nurses to sue for violations with remedies including reinstatement, back pay, attorneys' fees, and court costs.