HB 154 Summary

• Establishes mandatory minimum direct-care registered nurse-to-patient staffing ratios for all hospital units, ranging from 1:1 in operating rooms to 1:5 in rehabilitation and skilled nursing units

• Requires hospitals to convene nursing care committees with majority direct-care nurse representation to develop evidence-based staffing plans within 90 days

• Prohibits hospitals from using mandatory overtime, averaging ratios over time, mandatory layoffs, or video monitoring as substitutes for direct nurse observation to meet staffing requirements

• Grants registered nurses the right to refuse unsafe assignments without retaliation, and prohibits hospitals from disciplining or filing complaints with the nursing board based on such refusals

• Imposes fines of up to $25,000 per violation plus $10,000 per nursing unit shift for non-compliance, and creates a private cause of action for nurses seeking reinstatement, back pay, and damages