New Mexico 2025 Regular Session

New Mexico House Bill HB72 Compare Versions

Only one version of the bill is available at this time.

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28	28	HOUSE BILL 72
29	29	57
30	30	TH LEGISLATURE
31	31	-
32	32
33	33	STATE
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35	35	OF
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37	37	NEW
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39	39	MEXICO
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41	41	-
42	42	FIRST SESSION
43	43	,
44	44
45	45	2025
46	46	INTRODUCED BY
47	47	Eleanor Chávez
48	48	AN ACT
49	49	RELATING TO HEALTH CARE; REQUIRING THE HEALTH CARE AUTHORITY TO
50	50	PROMULGATE AND ENFORCE MINIMUM NURSING STAFF-TO-PATIENT RATIOS
51	51	IN LICENSED HOSPITALS; CREATING THE STAFFING ADVISORY
52	52	COMMITTEE; REQUIRING LICENSED HOSPITALS TO DEVELOP AND
53	53	IMPLEMENT POLICIES AND PROCEDURES; PROVIDING ADMINISTRATIVE
54	54	PENALTIES; DECLARING AN EMERGENCY.
55	55	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
56	56	SECTION 1. A new section of the Health Care Code is
57	57	enacted to read:
58	58	"[NEW MATERIAL] HOSPITAL STAFFING RATIOS--DEFINITIONS.--As
59	59	used in Sections 1 through 5 of this 2025 act:
60	60	A. "critical care unit" means a unit that is
61	61	established to treat patients whose severity of medical
62	62	conditions require continuous monitoring and complex
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90	90	intervention by licensed nurses;
91	91	B. "hospital" means any public, private for-profit
92	92	or not-for-profit acute care, rehabilitation, limited services,
93	93	critical access, general or specific facility offering
94	94	inpatient services, nursing and overnight care seven days per
95	95	week on a twenty-four-hour basis that is capable of treating no
96	96	fewer than three patients for the purposes of diagnosing,
97	97	treating and providing medical, psychological or surgical care
98	98	for physical or mental illness, disease, injury, rehabilitative
99	99	conditions and pregnancies; and
100	100	C. "hospital unit" includes critical care units,
101	101	burn units, labor and delivery rooms, post-anesthesia service
102	102	areas, emergency departments, operating rooms, pediatric units,
103	103	step-down or intermediate care units, specialty care units,
104	104	telemetry units, general medical care units, subacute care
105	105	units and transitional inpatient care units."
106	106	SECTION 2. A new section of the Health Care Code is
107	107	enacted to read:
108	108	"[NEW MATERIAL] HOSPITAL STAFFING RATIOS--STAFFING
109	109	ADVISORY COMMITTEE--CREATION--ORGANIZATION.--
110	110	A. The "staffing advisory committee" is created for
111	111	the purpose of advising the authority on matters related to
112	112	nurse staffing as provided in this 2025 act. The committee
113	113	consists of eleven members that reflect a geographic
114	114	representation of the state, appointed by the authority as
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143	143	follows:
144	144	(1) two members shall be private hospital
145	145	administrators or chief nursing officers;
146	146	(2) two members shall be public hospital
147	147	administrators or chief nursing officers;
148	148	(3) two members shall be nonmanagerial and
149	149	nonsupervisory employees of private hospitals involved in
150	150	direct patient care;
151	151	(4) two members shall be nonmanagerial and
152	152	nonsupervisory employees of public hospitals involved in direct
153	153	patient care;
154	154	(5) two members shall represent labor
155	155	organizations representing employees in public or private
156	156	hospitals; and
157	157	(6) one nonvoting advisory member shall
158	158	represent the authority.
159	159	B. The members of the staffing advisory committee
160	160	shall serve for terms of four years and no more than three
161	161	terms. A member appointed by the committee to fill a vacancy
162	162	shall serve the remainder of the term.
163	163	C. Term-length conditions for voting members
164	164	appointed to the staffing advisory committee are:
165	165	(1) for initial appointments, four members
166	166	shall serve for four-year terms, three members shall serve for
167	167	three-year terms, two members shall serve for two-year terms
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196	196	and one member shall serve for a one-year term;
197	197	(2) for regular appointments after the initial
198	198	appointments, four-year terms;
199	199	(3) for a vacancy appointment, the balance of
200	200	the term; and
201	201	(4) a committee member shall continue to serve
202	202	on the committee until a replacement is appointed.
203	203	D. The staffing advisory committee shall elect
204	204	annually a chair and other officers as the committee determines
205	205	to be necessary.
206	206	E. The staffing advisory committee shall meet at a
207	207	frequency necessary for the committee to advise and provide
208	208	data for the authority to use in promulgating rules pursuant to
209	209	Section 3 of this 2025 act.
210	210	F. A majority of the staffing advisory committee
211	211	members currently serving constitutes a quorum.
212	212	G. The authority may remove from office a member of
213	213	the staffing advisory committee for neglect of duties."
214	214	SECTION 3. A new section of the Health Care Code is
215	215	enacted to read:
216	216	"[NEW MATERIAL] HOSPITALS--LICENSED NURSE-TO-PATIENT
217	217	RATIOS--AUTHORITY--COMMITTEE--POWERS AND DUTIES.--
218	218	A. The authority, with the advice of the staffing
219	219	advisory committee, may:
220	220	(1) ensure that staffing ratios promulgated by
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249	249	the authority are maintained by a hospital;
250	250	(2) waive staffing ratios for rural general
251	251	acute care hospitals as needed to increase operational
252	252	efficiency; provided that doing so would not jeopardize the
253	253	health, safety and well-being of patients; and
254	254	(3) seek injunctive relief for violations of
255	255	this 2025 act.
256	256	B. By July 1, 2026, the authority, with the advice
257	257	of the staffing advisory committee, shall hold hearings and
258	258	promulgate rules regarding:
259	259	(1) minimum, specific and numerical staffing
260	260	ratios for hospitals licensed by the authority pursuant to the
261	261	Health Care Code, which shall include:
262	262	(a) licensed nurse-to-patient ratios by
263	263	licensed nurse classification and hospital unit; and
264	264	(b) unlicensed employee-to-patient
265	265	ratios by unlicensed classification and hospital unit for
266	266	unlicensed employees involved in direct patient care;
267	267	(2) rural general acute care hospital staffing
268	268	needs; provided that the ratios promulgated pursuant to
269	269	Paragraph (1) of this subsection may be adjusted to accommodate
270	270	these needs;
271	271	(3) emergency department staffing, which shall
272	272	include the ratios provided pursuant to Paragraph (1) of this
273	273	subsection but shall distinguish between regularly scheduled
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302	302	core staff licensed nurses and additional licensed nurses
303	303	required to treat critical care patients; and
304	304	(4) the documented patient classification
305	305	systems to be used by hospitals in determining nursing care
306	306	requirements, including the:
307	307	(a) severity of the illness to be
308	308	treated;
309	309	(b) need for specialized equipment and
310	310	technology;
311	311	(c) complexity of clinical judgment
312	312	needed to design, implement and evaluate the patient care plan
313	313	and the ability for self-care; and
314	314	(d) licensure of the personnel required
315	315	for care.
316	316	C. The rules promulgated by the authority pursuant
317	317	to Subsection B of this section shall not replace existing
318	318	nurse-to-patient ratios and unlicensed employee-to-patient
319	319	ratios that may exist as provided by rule or existing state or
320	320	federal law as of the effective date of this 2025 act.
321	321	D. The authority, in consultation with the staffing
322	322	advisory committee, shall:
323	323	(1) review the rules adopted pursuant to
324	324	Subsection B of this section after five years following the
325	325	adoption of the rules; and
326	326	(2) report proposed rules to the legislature
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355	355	prior to promulgation."
356	356	SECTION 4. A new section of the Health Care Code is
357	357	enacted to read:
358	358	"[NEW MATERIAL] HOSPITAL STAFFING RATIOS--HOSPITAL
359	359	POLICIES AND PROCEDURES--TRAINING.--
360	360	A. A hospital shall:
361	361	(1) employ staff to meet the staffing ratios
362	362	established by the authority, which shall be the minimum number
363	363	of registered and licensed nurses and unlicensed employees
364	364	involved in direct patient care; and
365	365	(2) adopt written policies and procedures for
366	366	nursing staff and unlicensed employees involved in direct
367	367	patient care and temporary personnel, which shall require:
368	368	(a) training and orientation for
369	369	providing direct patient care;
370	370	(b) orientation for registered nurses
371	371	and unlicensed employees sufficient to provide competent care
372	372	to patients in a nursing unit or clinical area prior to
373	373	assigning the registered nurse or unlicensed employees to those
374	374	areas; provided that the registered nurse or unlicensed
375	375	employee also demonstrates competency in providing care in the
376	376	assigned area; and
377	377	(c) temporary personnel orientation and
378	378	competency evaluation.
379	379	B. A hospital may employ additional staff in
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408	408	accordance with a documented patient classification system.
409	409	C. A hospital shall not:
410	410	(1) assign unlicensed personnel to perform
411	411	nursing functions in lieu of a registered nurse; or
412	412	(2) allow unlicensed personnel under the
413	413	direct clinical supervision of a registered nurse to perform
414	414	functions that require a substantial amount of scientific
415	415	knowledge and technical skills, including:
416	416	(a) administration of medication;
417	417	(b) venipuncture or intravenous therapy;
418	418	(c) parenteral or tube feedings;
419	419	(d) invasive procedures, including
420	420	inserting nasogastric tubes, inserting catheters and tracheal
421	421	suctioning;
422	422	(e) assessment of the condition of a
423	423	patient;
424	424	(f) educating patients and their
425	425	families concerning the patient's health care problems,
426	426	including post-discharge care; and
427	427	(g) moderate complexity laboratory
428	428	tests.
429	429	D. All hospitals shall adopt written policies and
430	430	procedures for training and orientation of nursing staff and
431	431	unlicensed employees involved in direct patient care. No
432	432	registered nurse or unlicensed employee involved in direct
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461	461	patient care shall be assigned to a nursing unit or clinical
462	462	area unless that nurse or unlicensed employee involved in
463	463	direct patient care has first received orientation in that
464	464	clinical area sufficient to provide competent care to patients
465	465	in that area and has demonstrated current competence in
466	466	providing care in that area. The written policies and
467	467	procedures for orientation of nursing staff and unlicensed
468	468	employees involved in direct patient care shall require that
469	469	all temporary personnel shall receive orientation and be
470	470	subject to competency validation.
471	471	E. Nothing in this section precludes a licensed or
472	472	registered nurse from working within that person's scope of
473	473	practice."
474	474	SECTION 5. A new section of the Health Care Code is
475	475	enacted to read:
476	476	"[NEW MATERIAL] HOSPITAL STAFFING RATIOS--VIOLATION--
477	477	ENFORCEMENT--REMEDIES.--
478	478	A. A hospital shall not deviate from any staffing
479	479	ratios established by the authority pursuant to this 2025 act
480	480	more than six times during a rolling thirty-day period. The
481	481	unit manager shall notify the staffing advisory committee and
482	482	the authority no later than ten days after each deviation.
483	483	Each subsequent deviation during the thirty-day period
484	484	constitutes a separate violation.
485	485	B. The authority shall, no later than July 1, 2026,
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514	514	adopt rules that establish a process for investigating and
515	515	remedying any violation of hospital staffing requirements. The
516	516	rules shall specify reporting requirements for deviations
517	517	consistent with this section and allow for the acceptance,
518	518	investigation and resolution of complaints from hospital staff,
519	519	exclusive representatives of hospital staff or members of the
520	520	public.
521	521	C. If the authority determines, whether through a
522	522	complaint process, hospital reporting or the authority's own
523	523	independent investigation, that a hospital has engaged in a
524	524	violation of staffing requirements, the authority shall:
525	525	(1) issue a warning for the first violation in
526	526	a four-year period;
527	527	(2) impose a civil penalty of one thousand
528	528	seven hundred fifty dollars ($1,750) for the second violation
529	529	of the same provision in a four-year period;
530	530	(3) impose a civil penalty of two thousand
531	531	five hundred dollars ($2,500) for the third violation of the
532	532	same provision in a four-year period; and
533	533	(4) impose a civil penalty of five thousand
534	534	dollars ($5,000) for the fourth and subsequent violations of
535	535	the same provision in a four-year period.
536	536	D. If the authority finds that a hospital has
537	537	committed multiple violations of the staffing ratio
538	538	requirements of a similar nature, it shall require the hospital
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567	567	to submit a corrective action plan for approval. If a hospital
568	568	does not follow the corrective action plan approved by the
569	569	authority, the hospital shall be fined fifty thousand dollars
570	570	($50,000) every thirty days until the hospital complies.
571	571	E. The requirements of this section or any rules
572	572	adopted pursuant to this 2025 act may be enforced by a civil
573	573	action brought by any interested person or organization for
574	574	injunctive relief to enforce the provisions of this section or
575	575	any rules adopted hereunder. In the event such a suit is at
576	576	least partially successful, the court may award the interested
577	577	person or organization litigation costs and reasonable attorney
578	578	fees.
579	579	F. A hospital is not required to follow the
580	580	staffing ratios established by the authority in the event of:
581	581	(1) a national or state emergency requiring
582	582	the implementation of a facility disaster plan;
583	583	(2) sudden and unforeseen adverse weather
584	584	conditions; or
585	585	(3) an infectious disease epidemic suffered by
586	586	hospital staff.
587	587	G. The authority may grant waivers to rural or
588	588	critical access hospitals for portions of this 2025 act if the
589	589	hospital is able to document reasonable efforts to obtain
590	590	adequate staff."
591	591	SECTION 6. EMERGENCY.--It is necessary for the public
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620	620	peace, health and safety that this act take effect immediately.
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