Nursing & Healthcare News

Will RN Staffing Ratios Go National?

What a federal staffing mandate could mean for California

Male nurse sits by a patient's bed holding her hand.

California has mandated minimum nurse staffing ratios for more than 20 years, but proposed federal rules could mean changes for our state too. Here’s what California nurses should know.

HR-2530 and S-1113

The ANA recently endorsed HR-2530 and S-1113, the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act, which would establish the first nationwide requirements for RN staffing.

If passed, this legislation would set federal limits on the number of patients that could be assigned to each direct care nurse, depending on unit type and patient acuity.

While the bills are structured much like California’s current nurse staffing rules and specify some of the same ratios, California nurses shouldn’t assume that new federal rules would have no impact.

Mandatory Minimums

This legislation would still allow states to set staffing requirements that are more stringent than the federal mandate, but not less. This means a federal staffing mandate wouldn’t reduce current state requirements, but it could impose stricter ones. The current bills before Congress specify ratios significantly stricter than California’s in several key areas. For example:

  • Postpartum units could assign no more than three mother-baby couplets per nurse; California currently allows up to four.
  • Acute care psychiatric units could assign no more than four patients per nurse; California currently allows ratios up to 6:1
  • Med-surg units would also be limited to four patients per nurse; the current California limit is 5:1.

Hospitals Take Note

If these bills become law in their present form, California hospitals would need to add additional nurses in certain units to comply with the federal requirements. That could lighten the workload for nurses in those areas, but would mean additional challenges for hospitals already struggling with nursing shortages. (The bills call for increases in Medicare reimbursement rates to help cover additional costs.)

A federal nurse staffing mandate could also create a more competitive interstate job market. Presently, only one other state (Oregon) imposes minimum staffing ratios for RNs, which has helped to keep skilled nurses in California. If similar protections were available nationwide, California hospitals would have to work harder to attract and retain nurses tempted by other states’ lower costs of living.

AARON SEVERSON is the associate editor of Working Nurse.

In this Article: ,

Latest Articles

Experience the Digital Flip Mag

Flip through the pages of the latest Working Nurse magazine on your device.