Nurse Overtime and Patient Safety Act of 2026

This legislation aims to enhance patient protection by imposing limits on the amount of mandatory overtime nurses can be required to work in certain healthcare providers that receive payments under the Medicare Program. Congress finds that long work hours for nurses contribute to fatigue, impaired vigilance, and medical errors, compromising patient safety, and notes that many states already restrict mandatory overtime. The bill prohibits providers from directly or indirectly requiring a nurse to work beyond a previously scheduled shift, more than 48 hours in any workweek, or more than 12 consecutive hours in a 24-hour period. Additionally, nurses cannot be required to work during the 10-hour period immediately following a 12-hour shift. Time spent in required meetings, training, or on-call duties counts as hours worked, but nurses are still permitted to volunteer for overtime. Exceptions to these limitations apply only during a declared emergency or disaster , and even then, providers must have made reasonable efforts to find alternative staffing. Such emergency work cannot extend beyond the emergency's end or the provider's direct response role, and is only permitted if a staff vacancy arises at the end of a shift and there is potential harm to an assigned patient if the nurse leaves. The bill includes strong whistleblower protections , safeguarding nurses from discrimination or retaliation for refusing mandatory overtime or reporting violations. Providers are required to develop and document clear policies on mandatory overtime, make them readily available to all nursing staff, and conspicuously post notices outlining nurses' rights under this subsection. They must also regularly post nurse schedules for transparency. Violations can result in civil money penalties of up to $10,000 per knowing violation, with more severe penalties for patterns of repeated offenses, and the Secretary of Health and Human Services will publish details of these penalties online. Furthermore, the bill mandates two studies: one by the Agency for Healthcare Research and Quality to establish appropriate standards for safe working hours for nurses, and another by the Office of Management and Budget to assess overtime practices in federally operated medical facilities. Importantly, this legislation does not preempt any state law that offers greater protections regarding mandatory overtime for nurses.