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Bill

Bill

A 2418

Requires hospitals to establish nurse staffing committees.

2026-2027 Regular Session Introduced by Joe Danielsen and 1 co-sponsor

Hospitals must create a nurse staffing committee dominated by direct-care RNs to develop and enforce unit-specific, evidence-based staffing plans with transparency and penalties fo

Introduced, Referred to Assembly Health Infrastructure Committee
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Bill Summary · A 2418

Summary of Bill A 2418 (Session 222) – New Jersey

Main purpose and intent

  • Requires hospitals licensed in New Jersey to establish a nurse staffing committee as a condition of licensure.
  • Aims to improve patient safety and care quality by giving direct-care nurses a formal, ongoing role in planning and overseeing nurse staffing levels, informed by evidence on how staffing affects outcomes, safety, and staff well-being.

Key provisions and changes

  • Scope and definitions:
    • Applies to hospitals licensed under New Jersey law.
    • Defines terms: intensity, nursing personnel, patient care unit, skill mix, and unforeseen emergency circumstance.
  • Nurse staffing committee (Section 3):
    • Hospitals must establish a nurse staffing committee, either as a new entity or by assigning duties to an existing committee.
    • Composition: at least 55% registered nurses (RNs) providing direct patient care; no more than 45% hospital administrative staff.
    • Selection: RN members chosen by peers (if no relevant collective bargaining agreement, then by peers; otherwise, per CBA). Administrative members appointed by the hospital CEO.
    • Time and compensation: committee participation must occur on scheduled work time and be compensated; members are relieved of other duties during meetings.
  • Primary responsibilities of the committee:
    • Develop and oversee an annual patient care unit and shift-based nurse staffing plan, to be the primary component of the staffing budget; establish upwardly adjustable minimum RN-to-patient ratios by unit and shift.
    • Consider multiple factors (census, admissions/discharges/transfers, care intensity, skill mix, experience/certifications, equipment needs, unit layout, applicable guidelines, other personnel, data on outcomes, finances, and break/rest needs).
    • Semiannual plan reviews against patient needs and evidence-based staffing data; assess and respond to staffing concerns.
  • Plan requirements and oversight:
    • Staffing plan must not weaken existing laws, rules, or CBAs.
    • Ensure RNs are assigned to units only if capable to provide care; allow emergency exemptions during states of emergency.
    • CEO must review the plan; if not adopted, provide written rationale and either adopt an adjusted plan or an alternate plan.
    • After one year, hospitals must submit adopted staffing plans to the Department of Health (DOH) and implement them; annual updates required.
  • Patient and complaint transparency:
    • Hospitals must post the staffing plan, shift-specific staffing schedules, and relevant staffing levels on each unit; make plans and current levels available to patients/visitors upon request.
    • Create a process to handle complaints about plan implementation; unresolved complaints may be escalated to the DOH.
    • Protections against retaliation for staff, patients, or others who raise concerns or participate in the committee.
  • DOH complaint process and enforcement (Section 4):
    • DOH procedures for filing and investigating complaints; investigations only after prior committee review and evidence of ongoing unresolved violations for at least 60 days.
    • DOH can require corrective action within 45 days of findings; civil penalties of up to $1,000 per day for noncompliance.
    • Publicly accessible DOH records of penalties and actions.
    • Requires an 18-month post-enactment report to the Governor and Legislature on complaints, investigations, costs, and recommendations.
  • Rules and effective date:
    • DOH to adopt implementing regulations under the Administrative Procedure Act.
    • Effective date: immediate.

Who is affected

  • Hospitals licensed in New Jersey (as a condition of licensure).
  • Nursing staff and other hospital personnel (as committee members and participants).
  • Hospital administration and leadership (interaction with the committee and compliance requirements).
  • Patients and the public (via posted staffing information and complaint processes).

Procedural and timeline aspects

  • Within one year after enactment: hospitals must submit their adopted staffing plan to the DOH and begin implementing it.
  • Ongoing: semiannual plan reviews; annual plan submissions and updates; ongoing posting and accessibility requirements.
  • DOH complaint investigations and penalties apply if violations occur, with annual reporting to the Governor and Legislature within 18 months of enactment.

Practical implications

  • Empowers frontline nurses with a formal mechanism to influence staffing decisions.
  • Balances patient care needs with operational and financial considerations in staffing budgets.
  • Introduces penalties for noncompliance, increasing accountability for hospital staffing practices.
  • Emphasizes transparency to patients and staff, though some operational details (e.g., how plans interact with CBAs) depend on existing agreements.

Compiled from official sources — confirm details with the bill’s official record.

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