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H.R. 3165 117th Congress House

Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021

Official title: 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: May 12, 2021 Introduced by: Janice D. Schakowsky Democratic · Illinois 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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Government employee pay, benefits, personnel managementGovernment information and archivesGovernment studies and investigationsHealth care qualityHealth facilities and institutionsHealth information and medical recordsHealth personnelHealth programs administration and fundingHealth technology, devices, suppliesHospital careIndian social and development programsLabor-management relationsMedicaidMedical educationMedicareMilitary medicineMinority healthNursingStudent aid and college costsVeterans' medical care
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This bill died when the 117th Congress ended
It never became law before the 117th Congress (2021–2022) 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 3 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
May 13, 2021
Referred to the Subcommittee on Health.
May 12, 2021
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
May 12, 2021
Introduced in House
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 Latest action May 13, 2021

Referred to the Subcommittee on Health.

 Plain-English summary Congressional Research Service

Nurse Staffing Standards for Patient Safety and Quality Care Act of 2021

This bill requires 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. Hospitals must post a notice regarding nurse-to-patient ratios in each unit and maintain records of actual ratios for each shift in each unit. The bill also requires hospitals to follow certain procedures regarding how ratios are determined and other staff are prohibited from performing nurse functions unless specifically authorized within a state's scope of practice rules, among other requirements.

HHS must adjust Medicare payments to hospitals to cover additional costs attributable to compliance with these ratios.

Nurses may object to, or refuse to participate in, an assignment if it would violate minimum ratios or if they are not prepared by education or experience to fulfill the assignment without compromising the safety of a patient or jeopardizing their nurse's license. Hospitals may not (1) take adverse actions against a nurse based on the nurse's reasonable refusal to accept an assignment; or (2) discriminate against individuals for good faith complaints relating to the care, services, or conditions of the hospital or related facilities. HHS may impose civil monetary penalties on hospitals violating the ratio requirements and must publish the names of such hospitals.

The bill provides stipends to the nurse workforce loan repayment and scholarship program and expands the nurse retention grant program to include nurse preceptorship and mentorship projects.

 Related & companion bills 3
  • HR 2530 Reintroduced Bill Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2023
  • HR 2581 Reintroduction of Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019
  • S 1567 Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021
 Bill text 1 version

Source documents hosted by congress.gov.

 Committees of jurisdiction 3
 Cosponsors 87
All 87 Democratic 59
D
Smith, Adam
Washington · Jul 12, 2022
Brown, Anthony
· Jun 8, 2022
 D
Castor, Kathy
Florida · Jun 8, 2022
 D
DeGette, Diana
Colorado · May 19, 2022
 D
Welch, Peter
Vermont · May 12, 2022
 D
Espaillat, Adriano
New York · May 11, 2022
 D
Gomez, Jimmy
California · May 11, 2022
 D
Ocasio-Cortez, Alexandria
New York · May 11, 2022
Lawson, Al
· Apr 28, 2022
 D
Beatty, Joyce
Ohio · Apr 7, 2022
 D
Krishnamoorthi, Raja
Illinois · Apr 7, 2022
 D
Foster, Bill
Illinois · Mar 18, 2022
Lamb, Conor
· Mar 18, 2022
McNerney, Jerry
· Mar 18, 2022
RYAN, TIM
· Mar 9, 2022
 D
Carson, André
Indiana · Mar 7, 2022
Cicilline, David
· Feb 28, 2022
 D
Soto, Darren
Florida · Feb 28, 2022
COOPER, JAMES
· Feb 18, 2022
 D
Nadler, Jerrold
New York · Feb 18, 2022
 D
Norton, Eleanor Holmes
District of Columbia · Feb 18, 2022
 D
Quigley, Mike
Illinois · Feb 7, 2022
 D
Swalwell, Eric
California · Feb 7, 2022
 D
Tlaib, Rashida
Michigan · Feb 7, 2022
 D
Williams, Nikema
Georgia · Feb 7, 2022
 D
Lieu, Ted
California · Feb 1, 2022
 D
Veasey, Marc A.
Texas · Feb 1, 2022
 D
McGovern, James P.
Massachusetts · Dec 16, 2021
 D
Sewell, Terri A.
Alabama · Dec 16, 2021
 D
Kaptur, Marcy
Ohio · Dec 8, 2021
 D
Meng, Grace
New York · Dec 8, 2021
Crist, Charlie
· Dec 7, 2021
 D
Dingell, Debbie
Michigan · Dec 7, 2021
 D
Jacobs, Sara
California · Dec 7, 2021
 D
Barragán, Nanette Diaz
California · Nov 9, 2021
 D
Sánchez, Linda T.
California · Nov 9, 2021
Bass, Karen
· Oct 25, 2021
Jackson Lee, Sheila
· Oct 25, 2021
MALONEY, CAROLYN
· Oct 25, 2021
ROYBAL-ALLARD, LUCILLE
· Oct 25, 2021
Cárdenas, Tony
· Oct 19, 2021
 D
Escobar, Veronica
Texas · Oct 19, 2021
 D
Hayes, Jahana
Connecticut · Oct 19, 2021
Levin, Andy
· Oct 19, 2021
 D
Pocan, Mark
Wisconsin · Oct 19, 2021
 D
Pressley, Ayanna
Massachusetts · Oct 19, 2021
 D
Raskin, Jamie
Maryland · Oct 19, 2021
 D
Wilson, Frederica S.
Florida · Oct 19, 2021
Bowman, Jamaal
· Sep 30, 2021
 D
Huffman, Jared
California · Sep 30, 2021
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Cite this page click to expand
APA
U.S. Congress. (2026). H.R. 3165: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021. 117th Congress. Open America. https://openamerica.io/bill/117-HR-3165/
MLA
"H.R. 3165: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021." 117th Congress, 2026, Open America, https://openamerica.io/bill/117-HR-3165/.
Bluebook (legal)
H.R. 3165, 117th Cong. (2026), https://openamerica.io/bill/117-HR-3165/.
Markdown link
[H.R. 3165: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021](https://openamerica.io/bill/117-HR-3165/)
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