The Safe Nursing and Patient Care Act (2005)
Introduced by Reps. Pete Stark (D-CA) and Steven LaTourette (R-OH) and
Sens. Edward Kennedy (D-MA) and John Kerry (D-MA)
PURPOSE: This bill addresses the twin problems
facing nurses in our country: protections for quality of nursing care
provided to patients and protections for maintaining the quality of the
profession by retaining experienced nurses in the workforce.
The bill limits the ability of hospitals and other health care
providers to require mandatory overtime from nurses. It would be
enforced through Medicare’s provider agreements. The legislation does
not cover nursing homes as there are alternative staffing/quality of
care proposals being pursued in that arena.
BILL SUMMARY
MANDATORY OVERTIME LIMITATIONS: Medicare’s
provider agreements would be amended to prohibit the use of mandatory
overtime for nurses in order to protect quality patient care, except in
the case of a declared state of emergency.
Mandatory overtime limitations would prohibit requirements that a nurse work in excess of any of the following:
The scheduled work shift or duty period of the nurse,
12 hours in a 24-hour period,
80 hours in a consecutive 14-day period.
And, which, if refused by the nurse, may result in an adverse
employment consequence to her or him. Voluntary overtime is not
affected.
A Declared state of emergency would be officially
declared by the federal government or appropriate state or local
government authority. It would not include staff shortages resulting
from labor disputes in the health industry or consistent understaffing
in a facility.
ENFORCEMENT: The Secretary of Health and Human
Services is provided the authority to investigate complaints for
violations of the above standard. If the Secretary finds a violation,
he/she shall require a plan of action to eliminate the occurrence of
such violation and is given the authority to issue civil monetary
penalties up to $10,000 for knowing violations and to increase those
penalties for patterns of repeated violations.
PROTECTIONS FOR NURSES: There will be a need to
protect nurses who choose to avail themselves of these new protections
in order to assure that they are not discriminated against by
employers. Therefore, the bill explicitly prohibits providers of
services from penalizing, discriminating, or retaliating in any manner
with respect to a nurse who avails themselves of these protections. In
order to remain protected by this act, a nurse would be required to
have acted in good faith.
POSTING OF INFORMATION: To assure that nurses are
fully aware of these new protections, the bill requires that providers
post these rights on a sign in an appropriate location in the workplace.
It also requires that providers post nurse schedules (for a period
of time to be determined by the Secretary) in a prominent location with
access to all nurses in the workplace and would require daily schedules
to be made available upon request.
POSTING OF PENALTIES: HHS would be required to
publish on their website the names of providers for which penalties
were imposed under this act. If a provider changes ownership,
violations under previous ownership would be eliminated from the site
after one year.
REPORTS
SAFE WORKING HOURS FOR NURSES: This legislation
protects patient safety by eliminating pressure on nurses to work
overtime beyond what they professionally believe to be safe for patient
care because of the very real threat of losing their jobs. However, it
remains true that working too long whether voluntarily or by mandate is
likely to detrimentally impact patient care. Unfortunately, no good
data exists today to provide us with accurate timeframes for safe
nursing care.
That is why we have included an important study by the Agency for
Healthcare Research and Quality to provide Congress with analysis of
appropriate standards for the maximum number of hours a nurse may work
without compromising quality patient care.
FEDERALLY OPERATED MEDICAL FACILITIES: Because
our legislation is enforced through Medicare, it will not cover many
government-run facilities. Nurses in these facilities also provide
direct patient care and may face similar mandatory overtime
demands. This study simply requires the Office of Management and Budget
to analyze those programs and to report back to Congress about whether
they are out of line with these new requirements and recommend changes
to bring those facilities into compliance.