Nurse Staffing Mandates: Top 9 Questions Answered


Pennsylvania’s new nurse staffing, or ‘safe staffing,’ mandate went into effect on July 1, 2023—requiring a minimum number of care staff at nursing homes per shift, per resident. This is the first mandate of its kind in Pennsylvania, and it is the latest in a push to ensure patients are receiving adequate care and that nurses have sufficient staffing and resources to be successful at their job.

In some states such as Minnesota, efforts to enact nurse staffing mandates or to form staffing committees (served in equal parts by direct care workers and hospital administrators) have failed, to the frustration of nurse unions and advocacy organizations.

PreCheck has compiled a list of frequently asked questions about nurse staffing mandates:

  • What is a nurse staffing mandate? A nurse staffing mandate, also called a ‘safe staffing’ mandate, is a set of regulations that dictate the minimum number of nurses required to be on staff per patient at any given time in a healthcare facility. These regulations are designed to ensure that patients receive the highest quality of care and that nurses are not overworked.
  • How do nurse-to-patient ratios impact patient care? When the nurse-to-patient ratio is too high, nurses may not have enough time to provide individualized attention and care to each patient. Research indicates high ratios increase the likelihood of patient death, length of hospital stay, and the chance of readmission within 30 days. When the ratio is low, patients report higher satisfaction.
  • Are there any regulations that dictate nurse-to-patient ratios? Yes, in some states, nurse-to-patient ratios are mandated by law. These regulations vary from state to state, but they all aim to ensure that patients receive the highest quality of care possible.
  • How does the nursing shortage impact hiring and retention? The nursing shortage has created an increased demand for nurses, which has made it difficult for employers to hire and retain qualified nurses. In turn, employers must often offer competitive salaries and other benefits to attract and retain the best nurses.
  • What are the implications of nurse staffing mandates on employers? These regulations require employers to hire additional nurses to meet the mandated ratios, which can be costly. In addition, employers must also ensure that they comply with the regulations or face potential fines or other penalties.
  • What can employers do to ensure compliance with nurse staffing mandates? Employers should be aware of the regulations in their state and ensure compliance with applicable mandated nurse-to-patient ratios. Employers should also be proactive in recruiting and retaining qualified nurses to meet the mandated ratios.
  • What are the benefits of nurse staffing mandates? Nurse staffing mandates help ensure that patients receive the highest quality of care possible. These regulations also help to protect nurses from being overworked and ensure that they have enough time to provide individualized attention and care to each patient.
  • Who is opposed to nurse staffing mandates? Frequently, hospital groups oppose nurse staffing mandates, citing reduced flexibility for nurses and less independence of units to determine their own staffing needs, as well as longer wait times for patients and possibly reduced services. Nurse staffing mandates would also increase most hospitals’ operating costs.
  • Who supports nurse staffing mandates? Nurse and patient advocates, such as the American Nurses Association. This group promotes nurse-led staffing committees so facilities can determine their own staffing needs, as well as legislated nurse to patient ratios and disclosure of staffing levels.

Nurse staffing mandates ultimately aim to ensure patients receive the highest quality of care, while also helping to address the nursing shortage through reduced stress and burnout for nursing staff. As these mandates become more common, partner with a background screener who thoroughly understands your needs in the healthcare industry.