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Bills Call For Nurse Staffing Quotas in Michigan Hospitals

Nurse filling out chartCalifornia is the only state in the country that has mandated nurse-to-patient ratio requirements for hospitals. If the Michigan Nurses Association and Democratic lawmakers are successful in their current legislative efforts, Michigan will be the second.

House Bill 4311 and Senate Bill 228 are identical bills recently introduced in each chamber by Representative Jon Switalski and Senator Rebekah Warren, respectively. The proposed legislation would require hospitals, including state-owned hospitals and state-owned facilities, to develop staffing plans that provide “sufficient, appropriately qualified nursing staff…in order to meet the individualized needs” of patients.

Significant provisions of the legislation include the following:

  • Hospitals would be required to develop an assessment tool that evaluates patient need levels and nursing care requirements for each hospital unit during each shift.
  • Hospitals would have to establish a staffing committee (consisting of at least 50% nurses) to assist in the development of a staffing plan.
  • Hospitals would be required to meet statewide minimum nurse-to-patient ratio requirements, which are dependent on the particular hospital unit (for example, the ratio for a critical care unit would be 1 to 1, while it would be 1 to 4 for a behavioral health unit).
  • A hospital that fails to submit an annual staffing plan or that does not meet the required staffing plan would be subject to a fine of up to $10,000 for each violation. Each day that the hospital fails to submit a plan or meet minimum staffing requirements would constitute a separate violation. Violations would be taken into account in licensure decisions.

As might be expected, hospitals have expressed concerns about the potential costs and administrative burdens of the legislation. According to a recent Associated Press Article, concerns as to the feasibility of meeting the ratio requirements have also been raised by the Michigan Health and Hospital Association (which opposes the legislation), in light of state and nationwide nurse shortages. On the other hand, the Michigan Nurses Association and other supporters have stressed that the legislation will improve patient safety.

For more information on how the legislation may impact your organization, please contact one of the health care law experts at Foster Swift.

Categories: Employment, Hospitals, Licensing, Regulatory


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