# 119-hr-3415: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2025

119-hr-3415, Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2025, is a 119th Congress bill sponsored by Rep. Schakowsky, Janice D. [D-IL-9] (D-IL); status introduced; PRIA reads it as touching household money (as of 2026-09-21).

- Canonical: https://policyrisk.com/legislation/119-hr-3415
- As of: 2026-09-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-3415
- Congress: 119
- Title: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2025
- Status: introduced
- Introduced: 2025-05-14
- Sponsor: Rep. Schakowsky, Janice D. [D-IL-9] (D-IL)
- Cosponsors: 49
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-09-21

## Summary

**Minimum nurse-to-patient ratios** would set national minimum direct-care nurse staffing levels, require hospitals to file prospective staffing plans, and add enforcement, transparency, and workforce programs to improve patient safety. - Patients and families: Would see lower nurse caseloads on many units, for example 1 patient per RN in trauma and operating rooms and 4 patients per RN on medical-surgical units. - Nurses and trainees: Would participate in creating and annually reevaluating staffing plans, gain legal protections against retaliation and access to a reporting hotline, and benefit from new scholarships, stipends, preceptorships, and retention grants. RN ratio deadlines are within 2 years or 4 years for rural hospitals. - Hospitals and federal health systems: Would have to comply to participate in Medicare and Medicaid, face civil money penalties up to $25,000 for a first knowing violation and $50,000 for subsequent violations, and receive Medicare payment adjustments aimed at offsetting net compliance costs.

## Cosponsors (49)

- Rep. Doggett, Lloyd [D-TX-37] (D-TX), 2025-05-14T00:00:00.000Z
- Rep. Cohen, Steve [D-TN-9] (D-TN), 2025-05-14T00:00:00.000Z
- Del. Norton, Eleanor Holmes [D-DC-At Large] (D-DC), 2025-05-14T00:00:00.000Z
- Rep. Casar, Greg [D-TX-35] (D-TX), 2025-05-14T00:00:00.000Z
- Rep. Brownley, Julia [D-CA-26] (D-CA), 2025-05-14T00:00:00.000Z
- Rep. Kelly, Robin L. [D-IL-2] (D-IL), 2025-05-14T00:00:00.000Z
- Rep. Quigley, Mike [D-IL-5] (D-IL), 2025-05-14T00:00:00.000Z
- Rep. Khanna, Ro [D-CA-17] (D-CA), 2025-05-14T00:00:00.000Z
- Rep. Bonamici, Suzanne [D-OR-1] (D-OR), 2025-05-14T00:00:00.000Z
- Rep. Huffman, Jared [D-CA-2] (D-CA), 2025-05-14T00:00:00.000Z
- Rep. Ocasio-Cortez, Alexandria [D-NY-14] (D-NY), 2025-05-14T00:00:00.000Z
- Rep. Krishnamoorthi, Raja [D-IL-8] (D-IL), 2025-05-14T00:00:00.000Z
- Rep. McIver, LaMonica [D-NJ-10] (D-NJ), 2025-05-14T00:00:00.000Z
- Rep. Jayapal, Pramila [D-WA-7] (D-WA), 2025-05-14T00:00:00.000Z
- Rep. Chu, Judy [D-CA-28] (D-CA), 2025-05-14T00:00:00.000Z
- Rep. Tlaib, Rashida [D-MI-12] (D-MI), 2025-05-14T00:00:00.000Z
- Rep. Titus, Dina [D-NV-1] (D-NV), 2025-05-14T00:00:00.000Z
- Rep. Ramirez, Delia C. [D-IL-3] (D-IL), 2025-07-16T00:00:00.000Z
- Rep. Sykes, Emilia Strong [D-OH-13] (D-OH), 2025-07-16T00:00:00.000Z
- Rep. Omar, Ilhan [D-MN-5] (D-MN), 2025-07-16T00:00:00.000Z
- Rep. Pocan, Mark [D-WI-2] (D-WI), 2025-07-16T00:00:00.000Z
- Rep. Gomez, Jimmy [D-CA-34] (D-CA), 2025-07-16T00:00:00.000Z
- Rep. McCollum, Betty [D-MN-4] (D-MN), 2025-07-16T00:00:00.000Z
- Rep. Deluzio, Christopher R. [D-PA-17] (D-PA), 2025-07-16T00:00:00.000Z
- Rep. Thompson, Bennie G. [D-MS-2] (D-MS), 2025-07-16T00:00:00.000Z
- Rep. Vargas, Juan [D-CA-52] (D-CA), 2025-07-16T00:00:00.000Z
- Rep. Thanedar, Shri [D-MI-13] (D-MI), 2025-10-06T00:00:00.000Z
- Rep. Waters, Maxine [D-CA-43] (D-CA), 2025-10-06T00:00:00.000Z
- Rep. Dingell, Debbie [D-MI-6] (D-MI), 2025-10-06T00:00:00.000Z
- Rep. Clarke, Yvette D. [D-NY-9] (D-NY), 2025-10-06T00:00:00.000Z
- Rep. Sherman, Brad [D-CA-32] (D-CA), 2025-11-12T00:00:00.000Z
- Rep. Harder, Josh [D-CA-9] (D-CA), 2025-11-19T00:00:00.000Z
- Rep. Pressley, Ayanna [D-MA-7] (D-MA), 2025-12-17T00:00:00.000Z
- Rep. Foster, Bill [D-IL-11] (D-IL), 2025-12-17T00:00:00.000Z
- Rep. Grijalva, Adelita S. [D-AZ-7] (D-AZ), 2026-03-16T00:00:00.000Z
- Rep. Takano, Mark [D-CA-39] (D-CA), 2026-03-16T00:00:00.000Z
- Rep. Simon, Lateefah [D-CA-12] (D-CA), 2026-03-16T00:00:00.000Z
- Rep. Frost, Maxwell [D-FL-10] (D-FL), 2026-03-16T00:00:00.000Z
- Rep. Torres, Ritchie [D-NY-15] (D-NY), 2026-04-09T00:00:00.000Z
- Rep. Kennedy, Timothy M. [D-NY-26] (D-NY), 2026-04-14T00:00:00.000Z
- Rep. Pingree, Chellie [D-ME-1] (D-ME), 2026-05-11T00:00:00.000Z
- Rep. Randall, Emily [D-WA-6] (D-WA), 2026-06-09T00:00:00.000Z
- Rep. Barragán, Nanette Diaz [D-CA-44] (D-CA), 2026-06-18T00:00:00.000Z
- Rep. Stansbury, Melanie A. [D-NM-1] (D-NM), 2026-06-23T00:00:00.000Z
- Rep. Hayes, Jahana [D-CT-5] (D-CT), 2026-06-29T00:00:00.000Z
- Rep. McGovern, James P. [D-MA-2] (D-MA), 2026-07-20T00:00:00.000Z
- Rep. Lieu, Ted [D-CA-36] (D-CA), 2026-07-20T00:00:00.000Z
- Rep. Jackson, Jonathan L. [D-IL-1] (D-IL), 2026-08-06T00:00:00.000Z
- Rep. Raskin, Jamie [D-MD-8] (D-MD), 2026-08-17T00:00:00.000Z

## Provisions PRIA read

- New nurse-to-patient limits: benefit, high. This bill would set specific maximum patients per direct-care RN for each hospital unit. It would require unit competence and orientation before an RN counts toward ratios. The bill would bar averaging across shifts and mandatory overtime to meet ratios. The Secretary could apply or raise ratios fo…
- Hospital staffing plans and records: benefit, medium. This bill would require each hospital to submit a unit-level staffing plan within one year. Hospitals must keep shift-by-shift staffing records for at least three years. The Secretary would make submitted documentation public under rules. Hospitals must post a clear notice of staffing rights and co…
- Nurse training, scholarships, and studies: benefit, medium. This bill would expand grants to fund preceptorships, mentorships, and stipends for nursing students, new hires, and recent graduates. AHRQ must study LPN staffing and outpatient nurse staffing within one year to inform rules. The Secretary must set LPN staffing requirements within 18 months and ma…
- Federal hospitals must comply: benefit, medium. This bill would apply the new staffing rules to VA, Department of Defense, Indian Health Service, and other federal hospitals. Contracted staff would count as employees for the rules. Federal employees could enforce the rules through negotiated grievance procedures where specified.
- Enforcement, fines, and nurse protections: mixed, medium. This bill would let the HHS Secretary investigate complaints and require corrective plans for violating hospitals. It would allow civil fines up to $25,000 for a first knowing hospital violation and $50,000 for later knowing violations. Individuals who knowingly violate could face up to $20,000 per…
- Medicare and Medicaid payment rules: mixed, medium. This bill would make hospital compliance with the staffing title a condition for Medicare participation and for Medicaid payments. MedPAC must report to Congress within 2 years on net costs and savings and recommend payment changes. The Secretary must adjust non‑federal hospital Medicare payments t…

## Related bills

- 119-hr-7973: Momnibus Act
- 119-hr-7853: PrEP Access and Coverage Act of 2026
- 119-hr-20: Richard L. Trumka Protecting the Right to Organize Act of 2025
- 119-hr-5390: FAMILY Act
- 119-hr-15: Equality Act
- 119-hr-1589: American Dream and Promise Act of 2025

## Sources
- [119-hr-3415 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/3415)

## Related
- [119-hr-7973: Momnibus Act](https://policyrisk.com/legislation/119-hr-7973)
- [119-hr-7853: PrEP Access and Coverage Act of 2026](https://policyrisk.com/legislation/119-hr-7853)
- [119-hr-20: Richard L. Trumka Protecting the Right to Organize Act of 2025](https://policyrisk.com/legislation/119-hr-20)
- [119-hr-5390: FAMILY Act](https://policyrisk.com/legislation/119-hr-5390)
- [119-hr-15: Equality Act](https://policyrisk.com/legislation/119-hr-15)
- [119-hr-1589: American Dream and Promise Act of 2025](https://policyrisk.com/legislation/119-hr-1589)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-3415 (as of 2026-09-21).