House File 2168 - Introduced HOUSE FILE 2168 BY MASCHER A BILL FOR An Act establishing minimum nurse-to-patient ratios for 1 hospitals. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 5506HH (2) 85 ad/nh
H.F. 2168 Section 1. NEW SECTION . 135B.35 Nurse-to-patient ratios. 1 1. A hospital shall assign a direct care nurse to no more 2 than the following number of patients in the specified units 3 at all times during each shift: 4 a. One patient in a trauma or perioperative unit. 5 b. Two patients in a critical care unit. 6 c. Three patients in an emergency room unit. 7 d. Four patients in a medical-surgical unit. 8 e. Five patients in a rehabilitation unit. 9 f. Six patients in a well-baby nursery unit. 10 2. A “direct care nurse” for purposes of this section 11 includes a licensed practical nurse or registered nurse 12 licensed pursuant to chapter 152 or 152E. Licensed practical 13 nurses may constitute fifty percent or less of the direct care 14 nurses assigned to patient care on any unit, except where 15 registered nurses are required. Only registered nurses shall 16 be assigned to triage patients in emergency room units or to 17 critical trauma patients. 18 3. A hospital shall not average the number of patients and 19 the total number of direct care nurses assigned to patients in 20 a hospital unit during any one shift or over any period of time 21 for purposes of meeting the requirements under this section. 22 4. The requirements established in this section shall not 23 apply during a state of emergency if a hospital is requested or 24 expected to provide an exceptional level of emergency or other 25 medical services. 26 5. The requirements established in this section do not apply 27 to entities designated as critical access hospitals pursuant 28 to 42 U.S.C. §1395i-4. The direct care nurse-to-patient ratio 29 at a critical access hospital shall follow the standards set 30 in this section as is reasonable based on the hospital’s needs 31 and capabilities. 32 6. The department of inspections and appeals shall adopt 33 rules to administer this section. 34 EXPLANATION 35 -1- LSB 5506HH (2) 85 ad/nh 1/ 2
H.F. 2168 The inclusion of this explanation does not constitute agreement with 1 the explanation’s substance by the members of the general assembly. 2 This bill establishes minimum direct care nurse-to-patient 3 ratios for specific units within a hospital. The bill provides 4 that direct care nurses include registered nurses and licensed 5 practical nurses, but licensed practical nurses can only 6 account for 50 percent of the direct care nurses assigned in 7 a unit. 8 The bill contains exceptions for emergencies and critical 9 access hospitals. The bill directs the department of 10 inspections and appeals to adopt rules to administer the bill. 11 The department of inspections and appeals may deny, suspend, or 12 revoke a license if a hospital substantially fails to comply 13 with the minimum standards adopted in the bill. 14 -2- LSB 5506HH (2) 85 ad/nh 2/ 2