Staffing law, evaluated like it's written.
State staffing law is a patchwork of different kinds of law — hard ratios here, staffing committees there, disclosure duties and penalty regimes on top. Nightingale OS encodes the patchwork as data: every entry carries its verified source and the date it was verified, evaluation runs against live units and published shift records, and every result — including every refusal — lands in a tamper-evident ledger. A compliance tool that assumes is a liability. Ours refuses.
The patchwork, encoded with receipts.
The state staffing-regulation registry is a coded dataset, not a summary. Each entry states the law it encodes, the provisions it evaluates, its verification depth, and the date it was last verified. Pending bills are tracked — and never evaluated as enforceable law.
Fourteen states and the federal bench, entry by entry.
Every row below is a registry entry with its law and its last-verified date. Where a state's verification depth is partial, the registry says so — Nevada's entry is verified to the title level and discloses it.
| State | Status | Law encoded | What the entry evaluates | Verified |
|---|---|---|---|---|
| Oregon | Effective | HB 2697 | Thirteen unit-level ratios, a staffing-committee requirement, and missed-break penalties | 2026-07-11 |
| Washington | Phasing in | Washington healthcare labor standards | Compliance reporting, missed-break penalties, and corrective-plan penalties | 2026-06-10 |
| California | Effective | Title 22 (22 CCR §70217) | Five unit-level ratios plus a continuous-presence provision | 2026-06-10 |
| New York | Effective | PHL §2805-t (clinical staffing committees) | Two staffing-committee provisions, compliance reporting, and corrective-plan penalties | 2026-09-25 |
| Texas | Effective | HSC ch. 257 (staffing committees) | Two staffing-committee provisions and compliance reporting | 2026-09-25 |
| Ohio | Effective | ORC §3727.51-.53 (staffing plan) | A staffing-plan committee provision | 2026-09-25 |
| Vermont | Effective | 18 V.S.A. §1854 (public staffing disclosure) | Public staffing disclosure (compliance reporting) | 2026-09-25 |
| Massachusetts | Effective | MGL c.111 §231 (ICU staffing) | An ICU staffing ratio — its pending bill is tracked separately and never evaluated | 2026-09-25 |
| Nevada | Effective | NRS 449.242-.2425 (staffing committees) | Two staffing-committee provisions and compliance reporting — verification depth disclosed as title-level | 2026-09-25 |
| Illinois | Effective | 210 ILCS 85/10.10 (PA 102-0641, eff. 2021-08-27) | Staffing committees, compliance reporting, and corrective-plan penalties — committee composition percentages are not asserted where the statute leaves them ambiguous; a pending bill is tracked separately | 2026-09-25 |
| Maine | Pending | LD 1281 | Pending legislation — tracked, never evaluated as enforceable law | 2026-06-10 |
| Michigan | Pending | Safe Patient Care Act | Pending legislation — tracked, never evaluated as enforceable law | 2026-06-10 |
| Pennsylvania | Pending | Patient Safety Act | Pending legislation — tracked, never evaluated as enforceable law | 2026-06-10 |
| Minnesota | Pending | Quality Patient Care Act | Pending legislation — tracked, never evaluated as enforceable law | 2026-06-10 |
| Federal | Pending | HR 3415 / S 1709 | Pending federal bills — tracked, never evaluated as enforceable law | 2026-06-10 |
What the provision kinds mean. The 19 staffing-ratio provisions evaluate unit-level numeric ratios; the 10 staffing-committee provisions evaluate committee formation and duties; the 6 compliance-reporting provisions evaluate public disclosure duties. The remainder: 3 corrective-plan provisions, 2 missed-break penalty provisions, and 1 continuous-presence provision. (Source: stateStaffingRegulationRegistry.js provision kinds by count, verified 2026-09-25.) Coverage lists describe what the registry encodes — not a target market.
Evaluate. Attest. Correct.
The registry is the law side. Three shipped capabilities close the loop on the practice side.
1 — Evaluate live units
The ratio-compliance ledger derives its staffing inputs from the shift records the hospital already publishes — assigned Shift rows covering the moment, with charge and break-buffer roles excluded (Charge and Break Buffer) — and evaluates each unit against the registry's provisions for that state. Every evaluation, including every refusal, lands in the tamper-evident Decision ledger.
2 — Compose the attestation
The attestation pack composes the shift attestation bundle with hash-chain verification for regulatory submission — a per-pay-period packet a compliance officer files, not a screenshot of a dashboard.
3 — Correct the course
Overdue corrective actions escalate on a schedule — the corrective-action-escalation job runs daily, so a plan of correction that slips doesn't slip silently.
What it refuses — on purpose.
The registry's refusal codes are the product. Each one is a way compliance tooling quietly lies, refused by construction.
STATEREG_001
A pending bill is not a law. Pending states are tracked in the registry and their provisions are never evaluated as enforceable law — no matter how certain the outcome looks.
STATEREG_002
A ratio does not travel. A unit is evaluated against its own state's law — never against another state's ratio because the numbers look similar.
STATEREG_003
A stale entry is not current law. Evaluations require the entry to be current as of its verification date; an out-of-date entry is refused, not silently trusted.
STATEREG_004
Penalty math without records is refused. Where a law's penalty regime depends on records the platform doesn't hold, the evaluation says so instead of inventing the number.
Where the honesty tiers sit. The registry, the ratio-compliance ledger, and the attestation pack are built and surfaced in the product. The PBJ staffing-mix data loader is built but not yet client-surfaced (UNSURFACED — feature-catalogue status), so it is not marketed here as a screen. Pending states and the federal entries are registry-visible only, and are never evaluated as enforceable law.
Bring the patchwork to your next staffing committee.
The registry, the ledger, and the attestation pack are part of Nightingale OS — the evidence layer for governed hospital AI, built, led, and owned by nurses.
Evaluations run on shift records the hospital already publishes and public law. No EHR integration required.