PlainBillCongress, translated.Legislation. Context. Public interest.Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Congressional Research Service
Version 00 · Introduced in Senate · Apr 16, 2013
National Nursing Shortage Reform and Patient Advocacy Act - Amends the Public Health Service Act to require hospitals to implement a staffing plan that includes a minimum direct care registered nurse-to-patient ratio by unit, adjustments above the minimum ratio under appropriate circumstances, and compliance with minimum licensed practical nurse staffing requirements. Requires the Secretary of Health and Human Services (HHS) to develop a national acuity tool to establish nurse staffing requirements above minimum ratios.
Directs the Secretary to adjust Medicare payments to hospitals (including hospitals operated by the Department of Veterans Affairs [VA] and long-term care hospitals) to cover additional costs incurred in providing services to Medicare beneficiaries that are attributable to compliance with such ratios.
Gives a nurse the right to act as the patient's advocate, including by: (1) initiating action to improve health care or to change decisions or activities that are against the interests and wishes of the patient, and (2) giving the patient an opportunity to make an informed decision about health care before it is provided.
Showing the opening paragraphs of the official summary.
Authorizes a nurse to refuse to accept an assignment if it would violate minimum ratios under this Act or if the nurse is not prepared by education, training, or experience to fulfill the assignment without compromising the safety of any 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 patient, employee, or any other individual for good faith complaints or grievances relating to the care, services, or conditions of the hospital or of any affiliated or related facilities. Prohibits actions by hospitals to restrain such rights.
Makes conforming amendments to titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act as well as to requirements for the VA health benefits program.
Includes stipends in the nurse workforce loan repayment and scholarship program. Expands the nurse retention grant program to authorize programs to implement nurse preceptorship and mentorship projects.
People & committees
Sen. Boxer, Barbara [D-CA] · D–CA
Legislative record
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Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Introduced in Senate
Primary sources
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Source last updated: Aug 12, 2025. Consult Congress.gov for the current record.
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