Bill > H7863

This bill amends Chapter 23-17 of the General Laws concerning the licensing of health care facilities by adding a new section that establishes maximum patient assignments for registered nurses in various hospital units, aiming to improve patient safety. The bill defines "facility" to include general acute care hospitals and certain acute care units but excludes rehabilitation and long-term care facilities, and "health care workforce" as all personnel impacting patient care. It sets specific limits, such as one patient per registered nurse in intensive or critical care units, with exceptions for stable patients, and outlines different ratios for step-down/intermediate care, post-anesthesia care (PACU), operating room (OR), emergency departments, maternal child care, pediatric, psychiatric, medical/surgical/telemetry, observational/outpatient, transitional care, and rehabilitation units. Importantly, facilities must develop a "patient acuity system" to assess if lower patient assignments are needed based on factors like specialized equipment, intensity of care, staff skill mix, facility design, and patient communication needs, and this system requires certification by the department of health. The bill also mandates a similar acuity system for technologists and therapists and includes enforcement provisions with potential civil penalties of up to $25,000 per day for violations, though these are suspended during declared public health emergencies. It clarifies that collective bargaining agreements can establish even fewer patients per nurse, and that these new standards should not lead to understaffing of the overall health care workforce.