PA Safe Staffing Bills

Pennsylvania’s Proposed Legislation for Nurse-to-Patient Ratios

Nurse-to-patient ratios are the best way to ensure safe staffing and effective care for patients. Studies have shown that proper staffing saves lives, reduces errors, decreases complications, and improves patient satisfaction, while also reducing nurse fatigue and burnout.

As PASNAP has worked to organize new unions and give a voice to more nurses, we’ve heard again and again that staffing is a chief concern: In recent surveys from these newly organized hospitals, nearly 90% of nurses cited inadequate and unsafe staffing as a main cause of stress in their day-to-day work lives. PASNAP has worked hard to address this issue with strong contract language, but — with more hospital managers cutting corners and prioritizing profits over patients — it remains a serious concern at union and non-union hospitals alike.

PASNAP has worked with elected leaders in Pennsylvania to create and push for bipartisan legislation to improve staffing transparency, hold hospitals more accountable, and guarantee minimum staffing standards.

Senate Bill 336 and House Bill 833 would improve transparency. Unfortunately, most hospitals are very tight-lipped when it comes to their nurse staffing. This bill would require hospitals to gather and report information, making them more accountable and allowing consumers to make better choices on their care.

Senate Bill 214 and House Bill 1500 would establish safe patient limits, often called “nurse-to-patient ratios.” Modeled on successful legislation in California, this bill lays out safe guidelines on how many patients can be assigned to a single RN in a specific type of unit, based on the level of care required by patients. These limits are formulated using well established best practices to ensure that patients receive proper care and attention. Extensive research has shown that improved staffing reduces fatalities, medical errors, infections, accidents, and complications. In other words: Safe patient limits literally save lives.


Minimum Staffing Requirements of the Pennsylvania Hospital Patient Protection Act

These bills would establish minimum nurse-to-patient ratios. Implementation and enforcement would be overseen by the Department of Health. The proposed minimum ratios are in the chart below. Only direct care nurses can be counted in the ratios, and the ratios would cover all shifts. Nothing would preclude any facility from implementing higher nurse staffing levels.

The ratios shown in the Ratios Unit Chart below are the minimums that each hospital must follow in its staffing plan and must be adjusted upwards to reflect actual patient acuity. Click here for text of current Senate bill, currently in the Pennsylvania Senate Public Health and Welfare Committee.

Ratios Unit Chart
Type of Unit Minimum Standard
Operating Room
Trauma Emergency Room
Active Labor Patient
Conscious Sedation
1 RN : 1 Patient
Critical Care in the ER
Critical Care
Intensive Care
Neonatal Intensive Care
Labor and Delivery
Burn Unit
1 RN : 2 Patients
Emergency Room
1 RN : 3 Patients
Other Specialty Units
Pre-surgery, admissions units, ambulatory surgical units
1 RN : 4 Patients
Rehabilitation or Skilled Nursing Facility 1 RN : 5 Patients
Postpartum 1 RN : 6 Patients (3 Couplets)
1 RN : 2 Immediate Postpartum
Well-baby Nursery 1 RN : 5 Patients1 RN : 4 Recently Born

See Studies on Safe Staffing

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The U.S. Is Running Out of Nurses

Nurses checked on my mother—and us—multiple times an hour. Without them, we would have fallen apart.

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Victoria, Australia to guarantee minimum nurse-to-patient staffing ratios

“Nurse patient ratios are really important for patient safety,” Ms Hennessy said. “Nurse patient ratios are important because the greater the care and focus nurses are able to give to our patients, we know the better clinical outcomes that they have.”

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