A bipartisan group of federal lawmakers introduced legislation Aug. 6 that would bar hospitals and other Medicare-participating facilities from forcing nurses to work mandatory overtime, backed by civil penalties of up to $10,000 per violation.
The Nurse Overtime and Patient Safety Act — introduced by Sen. Jeff Merkley, D-Ore.; Rep. Doris Matsui, D-Calif.; and Rep. Jen Kiggans, MSN, RN, R-Va. — would prohibit facilities from requiring registered nurses, licensed practical nurses and licensed vocational nurses to work beyond a previously scheduled shift. Mr. Merkley first introduced the measure in 2024, but it did not advance.
Under the bill, facilities could not compel nurses to work more than 48 hours a week, more than 12 consecutive hours in a 24-hour period, or during the 10-hour rest window after a 12-hour shift. Nurses could still volunteer for extra shifts.
The measure carves out an exception for declared emergencies or disasters, but only if a facility shows it made reasonable efforts to staff the shift and a patient faces a risk of harm. Consistent understaffing and labor disputes would not qualify, according to the bill.
Covered facilities include hospitals, psychiatric hospitals, ASCs, home health agencies, clinics, rural health clinics and federally qualified health centers that participate in Medicare.
Facilities would also have to adopt written overtime policies, post nurse schedules by department and display signage informing nurses of their rights. The bill would shield nurses who refuse overtime or report violations from retaliation. Nurses could file complaints with HHS, which could impose penalties of up to $10,000 per knowing violation and publish violators’ names online.
The bill would also direct two federal studies: one on standards for safe working hours for nurses, and another gauging the extent to which facilities have overtime policies and practices that conflict with the new limits.
More than 50 organizations back the bill, according to an Aug. 12 news release from Mr. Merkley’s office. Those include the American Nurses Association and National Nurses United.
“Mandatory overtime is not a staffing strategy,” ANA President Jennifer Mensik Kennedy, PhD, RN, said in an Aug. 12 statement. “It is a symptom of systemic workforce challenges that put nurses in impossible positions and increase risk at the bedside through physical fatigue and burnout.”
Eighteen states already restrict mandatory overtime for nurses. If passed, the federal bill would take effect one year after enactment.
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