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