OH HB521

Establishes mandatory nurse-to-patient staffing ratios for Ohio hospitals, ranging from 1:1 in trauma emergency and operating rooms to 1:6 in postpartum and well-baby nurseries, with implementation required within 2 years (4 years for rural hospitals)

Creates the Nursing Student Loan-to-Grant Program with $20 million in appropriations ($10 million per year for FY 2026-2027), providing up to $3,000 annually per student (maximum 4 awards) that converts to a grant after completing a 5-year service obligation as a direct-care nurse or nursing faculty

Requires each hospital to establish a nurse staffing committee with at least 60% direct-care registered nurses elected by peers, who must approve all staffing plans before implementation

Imposes fines of $25,000 for first violations and $50,000 for subsequent violations on hospitals that fail to comply with staffing requirements, with fines deposited into the nurse education assistance fund

Prohibits hospitals from using mandatory overtime, video monitoring as a staffing substitute, or retaliation against nurses who object to unsafe assignments, and requires the Department of Health to audit hospitals every six months