HR3415119th CongressWALLET

Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2025

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.

Show full summary

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.

Personalized for You

How does this bill affect your finances?

Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.

Free to download

Bill Overview

Analyzed Economic Effects

6 provisions identified: 4 benefits, 0 costs, 2 mixed.

New nurse-to-patient limits

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 for similar units. Ratios would take effect no later than 2 years, and 4 years for rural hospitals.

Hospital staffing plans and records

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 complaint instructions, and give each inpatient the hotline number.

Nurse training, scholarships, and studies

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 make them effective within 2 years, or 4 years for rural hospitals. HRSA and HHS must report to Congress on staffing and retention at 2 and 5 years.

Federal hospitals must comply

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

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 violation. Nurses would get anti‑retaliation protections and a federal right to sue for wrongful discharge or retaliation. Collected penalties could be used to carry out the title.

Medicare and Medicaid payment rules

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 to cover net additional costs tied to compliance, taking MedPAC recommendations into account.

Sponsors & CoSponsors

Sponsor

Schakowsky

IL • D

Cosponsors

Rep. Doggett, Lloyd [D-TX-37]
TX • D
Sponsored 5/14/2025
Cohen
TN • D
Sponsored 5/14/2025
Del. Norton, Eleanor Holmes [D-DC-At Large]
DC • D
Sponsored 5/14/2025
Rep. Casar, Greg [D-TX-35]
TX • D
Sponsored 5/14/2025
Rep. Brownley, Julia [D-CA-26]
CA • D
Sponsored 5/14/2025
Rep. Kelly, Robin L. [D-IL-2]
IL • D
Sponsored 5/14/2025
Rep. Quigley, Mike [D-IL-5]
IL • D
Sponsored 5/14/2025
Khanna
CA • D
Sponsored 5/14/2025
Bonamici
OR • D
Sponsored 5/14/2025
Rep. Huffman, Jared [D-CA-2]
CA • D
Sponsored 5/14/2025
Ocasio-Cortez
NY • D
Sponsored 5/14/2025
Rep. Krishnamoorthi, Raja [D-IL-8]
IL • D
Sponsored 5/14/2025
Rep. McIver, LaMonica [D-NJ-10]
NJ • D
Sponsored 5/14/2025
Rep. Jayapal, Pramila [D-WA-7]
WA • D
Sponsored 5/14/2025
Rep. Chu, Judy [D-CA-28]
CA • D
Sponsored 5/14/2025
Rep. Tlaib, Rashida [D-MI-12]
MI • D
Sponsored 5/14/2025
Rep. Titus, Dina [D-NV-1]
NV • D
Sponsored 5/14/2025
Rep. Ramirez, Delia C. [D-IL-3]
IL • D
Sponsored 7/16/2025
Rep. Sykes, Emilia Strong [D-OH-13]
OH • D
Sponsored 7/16/2025
Rep. Omar, Ilhan [D-MN-5]
MN • D
Sponsored 7/16/2025
Rep. Pocan, Mark [D-WI-2]
WI • D
Sponsored 7/16/2025
Gomez
CA • D
Sponsored 7/16/2025
McCollum
MN • D
Sponsored 7/16/2025
Rep. Deluzio, Christopher R. [D-PA-17]
PA • D
Sponsored 7/16/2025
Thompson (MS)
MS • D
Sponsored 7/16/2025
Rep. Vargas, Juan [D-CA-52]
CA • D
Sponsored 7/16/2025
Rep. Thanedar, Shri [D-MI-13]
MI • D
Sponsored 10/6/2025
Rep. Waters, Maxine [D-CA-43]
CA • D
Sponsored 10/6/2025
Rep. Dingell, Debbie [D-MI-6]
MI • D
Sponsored 10/6/2025
Rep. Clarke, Yvette D. [D-NY-9]
NY • D
Sponsored 10/6/2025
Rep. Sherman, Brad [D-CA-32]
CA • D
Sponsored 11/12/2025
Rep. Harder, Josh [D-CA-9]
CA • D
Sponsored 11/19/2025
Rep. Pressley, Ayanna [D-MA-7]
MA • D
Sponsored 12/17/2025
Rep. Foster, Bill [D-IL-11]
IL • D
Sponsored 12/17/2025
Grijalva
AZ • D
Sponsored 3/16/2026
Rep. Takano, Mark [D-CA-39]
CA • D
Sponsored 3/16/2026
Simon
CA • D
Sponsored 3/16/2026
Rep. Frost, Maxwell [D-FL-10]
FL • D
Sponsored 3/16/2026
Rep. Torres, Ritchie [D-NY-15]
NY • D
Sponsored 4/9/2026
Kennedy (NY)
NY • D
Sponsored 4/14/2026
Pingree
ME • D
Sponsored 5/11/2026

Roll Call Votes

No roll call votes available for this bill.

View on Congress.gov

Related Bills

Live Policy Activity

Live

Surfaced from PRIA's policy knowledge graph, ranked by signal strength, connected by evidence.

Cached · 4 days ago19,042Bills3,503Fed Rules1,992Wiki8 signals surfaced

Now TrackingHR10135

Active· 7 days in stage

Not In My Barn Yard Act

Rep. Thompson, Glenn [R-PA-15] (R-PA)Wallet Impact

IntroducedAug 20

Cmte Reported,

Passed Origin Chbr,

Passed Second Chbr,

Resolving Diffs,

Enrolled,

Became Law,

Current StageIntroduced· 7d

Would block federal eminent domain for most agricultural land when a feasible alternative exists, defines covered land, and excludes tiny low‑income parcels.

DOL Rewrites Disability Rules for 'Merit-Based Opportunity' Push

RuleLabor DepartmentFederal Contract Compliance Programs OfficeSignificant Wallet

The U.S. Department of Labor is revising its implementing regulations for Section 503 of the Rehabilitation Act of 1973, as amended (Section 503). The revisions align the regulations with applicable law and recent executive orders, including Executive Order 14173, "Ending Illegal Discrimination and Restoring Merit-Based Opportunity," and Executive Order 14219, "Ensuring Lawful Governance and Implementing the President's `Department of Government Efficiency' Deregulatory Initiative."

Federal Rule6 days ago

Labor Updates Vietnam Vets' Job Rules After EO Shakeup

RuleLabor DepartmentFederal Contract Compliance Programs OfficeSignificant Wallet

The U.S. Department of Labor publishes this final rule to revise its implementing regulations for the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended (VEVRAA). These revisions will align the regulations with Executive Order 14173 and remove the VEVRAA regulations' cross-references to the Executive Order 11246 authority. Executive Order 11246 was revoked by Executive Order 14173 on January 21, 2025. This final rule also makes technical revisions to update the VEVRAA regulations' jurisdictional thresholds, which were adjusted for inflation by the Federal Acquisition Regulation Council on October 1, 2025.

Federal Rule6 days ago

Guam Harbor Locks Down for Secret Service VIP Visit

RuleHomeland Security DepartmentCoast Guard Wallet

The Coast Guard is establishing a temporary security zone for certain navigable waters of the Philippine Sea in the Pacific Ocean in Apra Harbor, Guam. The Coast Guard will only enforce this rule when the United States government officials or other persons under the protection of the Secret Service are present or expected to be present. This action is necessary to protect the official party, public, and surrounding waterways from terrorist acts, sabotage, or other subversive acts. Entry of vessels or persons into this zone is prohibited unless specifically authorized by the Captain of the Port, Forces Micronesia/Sector Guam.

Federal Rule6 days ago

NRC Drops Dull Nuke Licensing Reg Update – Zzz

RuleNuclear Regulatory Commission

Legislation1w ago

Expressing support for the designation of August 22, 2026, as "Chuck Brown Day", and honoring Chuck Brown's contributions to music and to the District of Columbia.

HRES1485Del. Norton, Eleanor Holmes [D-DC-At Large] (D-DC)

introduced

Designates August 22, 2026 as "Chuck Brown Day" to celebrate the 'Godfather of Go-Go' and his impact on Washington, D.C.'s music and civic life.

Legislation1w ago

No Insider Trading on National Security Act of 2026

HR10137Rep. Whitesides, George [D-CA-27] (D-CA)

introduced

Requires the DoD Inspector General to report by Jan 1, 2027 on complaints of insider trading in prediction and energy markets tied to Operation Epic Fury, including outcomes and safeguards.

How These Connect

· reasoned by PRIA's knowledge graph

Graph Connectionstructural100% confidence

Not In My Barn Yard ActLimit federal eminent domain on farms

“Bill HR10135 contains provision HR10135::prov_1”

Deep Dive

· Polipedia policy encyclopedia

Polipedia· Wildlife & Conservation

Back to Legislation

Summary

How does this bill affect your finances?

Bill Overview

Analyzed Economic Effects

High Impact

New nurse-to-patient limits

Medium Impact

Hospital staffing plans and records

Nurse training, scholarships, and studies

Federal hospitals must comply

Enforcement, fines, and nurse protections

Medicare and Medicaid payment rules

Sponsors & CoSponsors

Sponsor

Cosponsors

Roll Call Votes

Related Bills

Live Policy Activity

Not In My Barn Yard Act

Other Activity On This Topic

DOL Rewrites Disability Rules for 'Merit-Based Opportunity' Push

Labor Updates Vietnam Vets' Job Rules After EO Shakeup

Guam Harbor Locks Down for Secret Service VIP Visit

NRC Drops Dull Nuke Licensing Reg Update – Zzz

Expressing support for the designation of August 22, 2026, as "Chuck Brown Day", and honoring Chuck Brown's contributions to music and to the District of Columbia.

No Insider Trading on National Security Act of 2026

How These Connect

Deep Dive

Lacey Act — Wildlife & Plant Trafficking

Federal Grants Ecosystem — Formula vs. Competitive, Major Programs & the $800B Flow

Federal Money Flows — How $7 Trillion Moves

FCC Radio and Television Broadcast Regulations

Related Bills

Live Policy Activity

Not In My Barn Yard Act

Other Activity On This Topic

DOL Rewrites Disability Rules for 'Merit-Based Opportunity' Push

Labor Updates Vietnam Vets' Job Rules After EO Shakeup

Guam Harbor Locks Down for Secret Service VIP Visit

NRC Drops Dull Nuke Licensing Reg Update – Zzz

Expressing support for the designation of August 22, 2026, as "Chuck Brown Day", and honoring Chuck Brown's contributions to music and to the District of Columbia.

No Insider Trading on National Security Act of 2026

How These Connect

Deep Dive

Lacey Act — Wildlife & Plant Trafficking

Federal Grants Ecosystem — Formula vs. Competitive, Major Programs & the $800B Flow

Federal Money Flows — How $7 Trillion Moves

FCC Radio and Television Broadcast Regulations