Health official: NICUs fall under nurse staffing law
The head of an effort to implement the new nurse staffing law said Wednesday that the measure applies to neonatal intensive care units.
Marylou Sudders, who is also slated to ascend next year to the top of incoming Gov. Charlie Baker's health and human services secretariat, said a "plain reading" shows neonatal units, known as NICUs, fall under the law.
Lawmakers passed legislation this year subjecting intensive care units to nurse staffing ratios. The move was a bid to avoid two ballot questions pushed by the Massachusetts Nurses Association, including one proposal that called for more sweeping nurse staffing rules in hospitals.
The 309-word law includes a reference to the broad definition of general and specialty ICUs under the Department of Public Health licensure regulations, which include pediatric and neonatal intensive care units.
The law calls for a patient-nurse assignment ratio of 1:1 or 1:2 "depending on the stability of the patient as assessed by the acuity tool and by the staff nurses in the unit, including the nurse manager or a nurse manager's designee when needed to resolve a disagreement."
Under the law, the state Health Policy Commission, an independent body analyzing the Massachusetts health care market, must create the regulations on public reporting of hospital compliance, patient safety quality measures and the "acuity tool" that would be certified by the Department of Public Health.
Since the law's passage, the nurses union and the Massachusetts Hospital Association have battled over how to interpret it, with the hospital association arguing that the law was meant to apply to adult intensive care units.
"There are many issues involved in developing regulations to implement the new ICU staffing law, and some are quite complex," Tim Gens, executive vice president of the hospital association, said in an emailed statement. "While we read the statute as not applying to Neonatal Intensive Care Units for both legal and clinical reasons, we look forward to working with the HPC on this and any other regulatory issues that arise.”
The nurses' union and the hospital group have also vehemently disagreed over whether the law includes a default nurse staffing ratio.
David Seltz, the commission's executive director, said in their reading of it, the law does not require a default ratio. But he added that the commission has the regulatory ability in the creation of the acuity tool to potentially suggest that the tool should be based on a 1:1 default.
David Schildmeier, a spokesman for the nurses' union, pointed to a video they posted on their website of Sen. Stanley Rosenberg on the Senate floor explaining the law before it passed earlier this year. Schildmeier said the video shows the intent of the law is to have a 1:1 ratio.
"We were the ones in the room negotiating it with Senator Rosenberg," Schildmeier said. "And every word was in there for a reason."
Draft regulations from the Health Policy Commission, originally slated to be released by the end of the year, are tentatively set for release in early January.
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