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S 864 114th Congress Senate

National Nursing Shortage Reform and Patient Advocacy Act

Official title: A bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals, and for other purposes.

Introduced: September 29, 2015 See on congress.gov
Health Administrative law and regulatory proceduresCivil actions and liabilityDepartment of Health and Human ServicesEmployment discrimination and employee rights
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This bill died when the 114th Congress ended
It never became law before the 114th Congress (2015–2016) adjourned, and bills don't carry over to the next Congress. It would have to be reintroduced. You can still save it for reference, but it won't receive updates.
 Everywhere this bill has been 2 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
Mar 25, 2015
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Mar 25, 2015
Introduced in Senate
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 Latest action March 25, 2015

Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

 Plain-English summary Congressional Research Service

National Nursing Shortage Reform and Patient Advocacy Act

Amends the Public Health Service Act to require hospitals to implement and submit to the Department of Health and Human Services (HHS) a staffing plan that complies with specified minimum nurse-to-patient ratios by unit. Requires HHS to develop a transparent method for establishing nurse staffing requirements above minimum ratios.

Directs HHS to adjust Medicare payments to hospitals to cover additional costs incurred in providing services to Medicare beneficiaries that are attributable to compliance with such ratios.

Gives nurses the right to act as the patient's advocate by initiating action to improve health care and by giving the patient an opportunity to make informed health care decisions. Allows a nurse to object to, or refuse to participate in, any assignment if it would violate minimum ratios or if the nurse is not prepared by education or experience to fulfill the assignment without compromising the safety of a patient or jeopardizing the nurse's license. Prohibits a hospital from: (1) taking specified actions against a nurse based on the nurse's refusal to accept an assignment for such a reason; or (2) discriminating against any individual for good faith complaints relating to the care, services, or conditions of the hospital or of any related facilities.

Adds stipends to the nurse workforce loan repayment and scholarship program. Expands the nurse retention grant program to authorize programs to implement nurse preceptorship and mentorship projects.

 Related & companion bills 1
 Bill text 1 version

Source documents hosted by congress.gov.

 Committees of jurisdiction 1
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APA
U.S. Congress. (2026). S. 864: National Nursing Shortage Reform and Patient Advocacy Act. 114th Congress. Open America. https://openamerica.io/bill/114-S-864/
MLA
"S. 864: National Nursing Shortage Reform and Patient Advocacy Act." 114th Congress, 2026, Open America, https://openamerica.io/bill/114-S-864/.
Bluebook (legal)
S. 864, 114th Cong. (2026), https://openamerica.io/bill/114-S-864/.
Markdown link
[S. 864: National Nursing Shortage Reform and Patient Advocacy Act](https://openamerica.io/bill/114-S-864/)
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