Minnesota Hospital Association


March 06, 2023


 New analysis warns of severe negative impacts on patient care and access if "Keeping Nurses at the Bedside Act" is enacted    

March 06, 2023, Saint Paul, Minn.– According to an analysis by the Minnesota Hospital Association (MHA), a proposal in the legislature to implement nurse staffing ratios would have drastic, negative impacts on patient care, access, and cost, reducing availability of hospital care across the state. The proposed bill, SF 1561/HF 1700, aims to establish staffing committees with the power to set nurse staffing ratios. If a rigid registered nurse (RN) to patient ratio is implemented without flexibility to care for patients, MHA estimates it would reduce hospital care capacity by 15% and threaten care for 70,000 patients in Minnesota. The analysis also suggests that the proposed mandates would worsen the health care workforce crisis.    

"If implemented, these harmful mandates will reduce our ability to provide care, leading to potential unit closures, increased costs, longer wait times for patients, and the loss of vital health care services that communities rely on," warned Dr. Rahul Koranne, president and CEO of the MHA. "It is crucial that we maintain access to high-quality health care services and ensure that hospitals and health systems have the resources they need to continue caring for Minnesotans.”    

Currently, there are 40,000 open positions in the health care sector with over 5,000 open RN positions in the state. Mandating a fixed RN to patient ratio during these unprecedented shortages will inevitably lead to reduction in hospital services and a loss of needed hospital care for more than 70,000 patients annually.     

If a hospital cannot meet the mandated RN to patient ratio, it will be forced to close units, hire costly traveling nurses, limit admissions, and be unable to fulfill its mission of acting as the ultimate 24x7 safety net for the communities it serves. Relying on nurse staffing agencies in hospitals results in increased health care costs for patients, employers, and communities. Hospitals and health systems work hard day and night to provide access to emergency, surgical, and medical services to all patients and having a mandate that affects even one patient negatively is unconscionable.     

Committee-driven or mandated staffing ratios also ignore important factors such as patient acuity, nurse experience, or the valuable care provided by other members of the care team, including licensed practical nurses (LPNs), nurses’ aides, respiratory therapists, physical therapists, pharmacists, and physicians. Without the flexibility to make staffing adjustments to more accurately meet the needs of actual patients being treated in real-time, hospitals will be forced to close units to new patients and these closures will directly affect the non-RN professionals on the care team.    

As our hospitals and health systems continue to grapple with the ongoing challenges of discharge backlogs, unprecedented workforce shortages and very difficult finances, it is critical to understand the potential impacts before implementing any changes that could have far-reaching consequences. Instead of creating barriers to patient care, there are productive investments the legislature can make in patient care and the health care workforce:   

  • Significant investments are needed in the health care workforce through existing and new retention, recruitment, and development strategies. There are still over 5,000 open nursing positions in Minnesota and these efforts, not staffing ratios, will help fill them.   
  • Expansion of the loan forgiveness program, including the $5 million suggested for nurses by the Minnesota Nurses Association (MNA). MHA would also like to include other health care professionals who are critically important care team members.   
  • Support additional mental health funding potentially with a grant program targeting the mental health needs of health care providers.    

Hospitals and health systems in Minnesota care for their patients 24 hours a day, seven days a week, 365 days a year, and SF 1561/HF 1700 threatens this core patient service mission. The staffing provisions within the bill are untenable for hospitals and health systems and will inevitably hurt our communities by limiting care for patients. 


About MHA    
The Minnesota Hospital Association (MHA) represents Minnesota’s hospitals and health systems, which employ more than 127,000 people, provide high-quality care for patients, and meet the needs of communities. Since 1917, MHA has worked to provide Minnesota’s hospitals and health systems with the resources, best practices, and guidance to provide an exceptional patient experience and high-quality, affordable care that extends beyond the hospital’s walls.