Safe Staffing

For decades, Pennsylvania nurses and healthcare professionals have been calling for enforceable nurse-to-patient staffing standards that keep patients safe and nurses at the bedside. When staffing is unsafe, patients wait longer for care, errors increase, and nurses burn out faster—driving experienced caregivers out of the profession and worsening the staffing crisis.

Hospitals cannot be left to police themselves; the solution must come from legislation and regulations.

That’s why PASNAP is fighting for House Bill 106, the Patient Safety Act, which would set minimum safe nurse-to-patient ratios across hospital units in Pennsylvania. The bill is modeled after California’s groundbreaking law, which has saved lives, reduced nurse turnover, and improved care without harming hospital finances. We also are fighting to embed these ratios into Pennsylvania’s hospital regulations, ensuring they are permanent, enforceable, and consistent statewide.

On June 28, 2023, due to the advocacy and efforts of PASNAP Members, HB106 passed the PA House of Representatives 119-84. This marked the first time the Pennsylvania legislature considered and voted on a bill that would mandate ratios.

We have more work to do - and we are not giving up until we get it done.

CURRENT FIGHT

HB 106 passed the Pennsylvania House with growing bipartisan support in 2023. Now, we are fighting to get ratios into Pennsylvaina’s hospital regulations. We’ve been here before with Act 102 and HB 926—and we know how to win. Because every Pennsylvanian deserves safe, quality care, and every nurse deserves the conditions to provide it.

Join us in this fight

WHY STAFFING STANDARDS MATTER

Unsafe staffing isn't new—and it's not because there aren't enough nurses. It's the result of years of intentional understaffing by some hospital administrators to cut costs. This practice drives up patient harm, increases nurse burnout, and ultimately costs hospitals more through turnover, readmissions, and lawsuits.

Under HB106:

ICU: No more than 1 patient for every 2 nurses.
Surgical Units: No more than 1 patient for every 5 nurses.
Emergency Departments: Specific, acuity-based caps for patient safety.
Safe Harbor: Legal protections for nurses who refuse unsafe assignments in good faith.

WHAT PENNSYLVANIA NURSES SAY

In PASNAP's 2024 survey:

78% said they've been assigned more patients than they can safely care for.

70% reported missing critical patient care tasks due to heavy workloads.

62% said unsafe staffing was a major reason they've considered leaving the bedside.

When nurses are overloaded, it's patients who suffer—through longer wait times, delayed medications, missed assessments, and preventable complications.

HOW PASNAP USES OUR POWER

PASNAP's 11,000 members are mobilizing across the Commonwealth to win safe staffing for every hospital patient:

Legislative Advocacy: Pushing HB 106 and its Senate companion through the legislature.
Regulatory Change: Working to incorporate nurse-to-patient ratios into state hospital regulations.
Public Education: Making sure patients and families know how unsafe staffing affects their care.
Research & Data: Using decades of studies to counter industry myths about costs and feasibility.

Our movement is part of a national push to make safe staffing the law—not a suggestion—and to hold hospitals accountable for meeting patient safety standards every day.

RESEARCH

Decades of research and the results from the places where patient safety standards have been implemented—in California, Massachusetts, and internationally—have shown that they work—that, in fact, they are the only approach that works.

That's why 90% of the public support mandatory staffing standards, and why momentum is growing to enact them in other states. A safe staffing bill much like ours in Pennsylvania just recently passed in Oregon. In addition to PA, the following states have pending safe staffing legislation: Connecticut, Georgia, Illinois, Maine, Michigan, and New Jersey.

Safe Staffing Standards in PA Hospitals Will Save Lives…and Money

The Center for Health Outcomes and Policy Research at UPenn estimates that HB106, if implemented in PA, would have the following positive impacts on patient care. Just looking at med surg units alone (impacts across all units would be much greater):

1,155 hospital deaths would be prevented annually.
771 hospital readmissions would be avoided annually.
Length of stay would be reduced by 34,919 days annually.

These patient care impacts would lead to substantial cost savings for hospitals (again, these estimates consider med surg units only and would be much greater across all hospital units):

Reducing length of stay by 39K days annually—would save $93 million
Hospitals would see additional savings from higher satisfaction, avoiding readmission penalties, reducing turnover, and reducing burnout

Further cost reductions would come from reducing nurse turnover. The estimated cost of replacing a nurse is $88K. If the current turnover rate of 30% were cut in half to 15%, it would save hospitals $650 million per year.

Safe Staffing Saves Lives