Ohio nurses, lawmakers push bipartisan bills to fix hospital staffing crisis

The Ohio Nurses Association applauded the introduction of two pieces of legislation that together form a bipartisan effort to address understaffing in Ohio’s hospital system.

The Ohio Nurse Workforce and Safe Patient Act (HB 521), sponsored by Reps. Crystal Lett (D-Columbus) and Christine Cockley (D-Columbus), and the Nurse Staffing Committee Reform Bill (HB 351), sponsored by Rep. Brian Lorenz (R-Powell), work in tandem to confront the crisis of nurse burnout, unsafe workloads and preventable patient harm.

“These bills represent the answer to the question we hear every day from Ohio nurses, patients and families — what can be done about chronic understaffing in hospitals?” said Rick Lucas, RN, president of the Ohio Nurses Association. “The answer is accountability, transparency and putting bedside nurses in control of decisions that affect patient safety.”

HB 521 sets statewide, evidence-based minimum nurse-to-patient ratios across hospital units, includes whistleblower protections, and creates enforcement mechanisms to ensure compliance. It also invests in the future of the nursing workforce through a Nursing Student Loan-to-Grant Program, providing $20 million in state funding to help students enter and remain in the profession.

“Understaffing isn’t just a workforce issue; it’s a public safety issue,” Lucas said. “When one nurse is responsible for too many patients, mistakes can happen, delays in care occur and patients suffer. HB 521 is the comprehensive solution Ohio needs to keep hospitals safe, nurses supported and patients protected.”

In small and rural hospitals — from Coshocton to Defiance — the impact of short staffing is especially severe. When one nurse becomes sick or one bed opens unexpectedly, entire units are stretched beyond capacity. In many communities there is no backup. This means delayed emergency care, diverted ambulances and patients traveling hours to find an open bed.

“This is about saving access to care in rural Ohio,” Lucas said. “Every minute matters when someone is in a health crisis. We’re seeing heart attacks, strokes and traumas where delays in treatment, caused by staffing shortages, are literally costing lives. Families are watching loved ones suffer or die from conditions that should have been preventable. That’s unacceptable, and it’s exactly why these reforms are so urgently needed.”

Complementing HB 521, The Nurse Staffing Committee Reform Bill, introduced by Lorenz, strengthens Ohio’s existing staffing law (ORC 3727.50 et seq.) to ensure frontline nurses have binding authority in staffing decisions at the unit level. The bill requires that at least 51% of each hospital staffing committee be made up of direct-care nurses, elected by their peers. These committees will develop and approve unit-specific minimum staffing levels based on patient acuity and evidence-based safe nurse staffing standards.

Hospitals must adopt and implement the approved plans for a two-year period, file them with the Ohio Department of Health, and adhere to them at least 80% of the time. Hospitals also will be required to submit quarterly compliance reports, certified by the chief nursing officer and a direct-care nurse committee co-chair, which will be made publicly available on the department’s website.

The Department of Health may audit hospitals or impose fines on those failing to make a “prompt and diligent effort” to comply with their staffing plans, with penalties directed toward Ohio’s Nurse Education Grant Program to strengthen the pipeline of future nurses.

HB 535 also establishes an incentive program through the Bureau of Workers’ Compensation to reward hospitals that meet or exceed staffing compliance thresholds with premium discounts.

“This bill gives nurses a real seat at the table — not as advisers, but as partners in making patient-safety decisions,” Lucas said. “Rep. Lorenz’s leadership shows that safe staffing isn’t a partisan issue; it’s a matter of saving lives."

Together, HB 521 and HB 535 form a bipartisan package of solutions that balances immediate, hospital-driven reforms with long-term, statewide accountability.

“This is what leadership looks like,” Lucas said, “Democrats and Republicans coming together to protect Ohio’s patients, support our health care workers and rebuild a system that’s been stretched to the breaking point.

“Every patient deserves safe, high-quality care no matter their ZIP code. These bills finally put patient safety where it belongs — above profit, politics and bureaucracy.”