Minnesota lawmakers removed the most contentious part of a nurse staffing bill Monday amid pressure from Mayo Clinic and other health systems.
Differing versions of the legislation that passed the Minnesota Senate and House in recent weeks would have required hospitals to establish committees of nurses, other direct caregivers and executives to set staffing levels for inpatient care units. Rochester, Minnesota-based Mayo Clinic, the largest health system in the North Star State, threatened to pull billions of dollars in planned construction in the state if that provision became law. Legislators then carved out an exemption for Mayo, drawing criticism from other Minnesota health systems.
In the final hours of the 2023 legislative session Monday night, lawmakers removed the staffing committee mandate and the exemption for the Mayo Clinic. The bill would still require hospitals to form committees to address workplace violence. In addition, the Department of Health would establish a loan forgiveness program for nurses and other practitioners—75% of which would be devoted to rural providers—and publish an independent report on nurse turnover.
State Rep. Sandra Feist (D) and state Sen. Erin Murphy (D), the bill's lead sponsors, lauded its provisions for workplace safety, financial aid and nurse turnover but expressed disappointed that the legislation was “subsumed by a fight among corporate entities.”
“This was a really excellent, very thoughtful, very well-crafted compromise bill,” Feist said during a news conference Monday following passage of the Nurse Patient Safety Act (formerly the Keeping Nurses at the Bedside Act). “It really tells me a lot about this place that a bill like that can’t pass into law. It is incredibly disappointing,” she said.
“The corporate power in healthcare is real, and we touched it, and it pushed back,” Murphy said. “Despite that, we continue to fight.”
Mayo Clinic President and CEO Dr. Gianrico Farrugia said in a statement that the company is "thankful to Gov. [Tim] Walz [(D)] and his team for their exceptional partnership and leadership. Gov. Walz, Speaker [Melissa] Hortman [(D)] and [Senate] Majority Leader [Kari] Dziedzic [(D)] have expressed firm support for Mayo Clinic and for our desire to grow and invest in healthcare and our communities."
The Mayo Clinic argued that providers such as itself that use acuity-based staffing software should be exempt from staffing requirements. Administrators and nurses from other Minnesota hospitals and criticized the Mayo Clinic carve-out.
Hospital and health system representatives also maintained that a staffing requirement isn’t feasible amid a labor shortage, contending it would lead to service cuts if employers couldn’t comply with the rules.
The Minnesota Hospital Association said in a statement that it appreciated lawmakers' "thoughtful consideration and their willingness to listen to our concerns regarding legislation impacting patient care.”
The Minnesota Nurses Association supported the bill amid job cuts, understaffing, rising workplace violence and worsening burnout. Association President Mary Turner said in a statement that “because of the power and influence of corporate healthcare executives, that bill has died.”
The nurses union and hospital industry backed similar legislation enacted in 2014 that was limited to a call for research on staffing after provider opposition caused legislators to back off from minimum staffing requirements.
The Minnesota Legislature this year also scrapped plans to penalize hospitals that exceed cost growth benchmarks, which the Mayo Clinic also opposed. Instead, lawmakers approved a measure establishing a study on healthcare costs.