prevention program within 6 months of the date of 
promulgation of the interim final standard, which 
program shall include hazard identification, risk as-
sessments, and control measures in relation to pa-
tient care duties and patient handling. 
(2) TECHNOLOGY AND EQUIPMENT PURCHASE 
AND MANAGEMENT.—A requirement that, within 2 
years of the date of issuance by the Secretary of an 
interim final standard, each health care employer 
shall purchase, use, maintain, and make accessible 
to health care workers, such safe patient handling 
equipment, technology, and accessories as the Sec-
retary determines appropriate. 
(3) HEALTH CARE WORKER PARTICIPATION.—A 
requirement that each health care employer shall ob-
tain input from health care workers, to include di-
rect care registered nurses, health care workers, 
their representatives, and their collective bargaining 
agents, in developing and implementing the safe pa-
tient handling, mobility, and injury prevention pro-
gram, including training and education and the pur-
chase of technology and equipment and necessary 
accessories. 
(4) DATA TRACKING AND REVIEW.—A require-
ment that each health care employer shall establish 
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a review program to analyze data relevant to the im-
plementation of the employers’ safe patient handling, 
mobility, and injury prevention program, and shall 
account for circumstances where safe patient han-
dling technology or equipment were not utilized in 
accordance with the health care employers’ safe pa-
tient handling, mobility, and injury prevention 
standard. Each health care employer shall upon re-
quest, make available their findings and data used 
in such review, to health care workers, their rep-
resentatives, their collective bargaining agents, and 
the Secretary or other Federal agency. Each health 
care employer shall maintain the data and findings 
from their review for at least 5 years 
(5) INCORPORATION OF TECHNOLOGY INTO FA-
CILITIES.—A requirement that each health care em-
ployer shall consider the feasibility of incorporating 
safe patient handling technology as part of process 
of new facility design and construction, or facility re-
modeling. 
(6) EDUCATION
AND
TRAINING.—A require-
ment that each health care employer shall train 
health care workers on safe patient handling, mobil-
ity, and injury prevention policies, technology, equip-
ment, and devices, initially, and on a continuing an-
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nual basis, and as necessary. Such training shall 
prepare health care workers, to identify, assess, and 
control musculoskeletal hazards of a general nature, 
and those specific to particular patient care areas, 
and shall be conducted by an individual with knowl-
edge in the subject matter, and delivered, at least in 
part, in an interactive simulated point-of-care train-
ing and hands-on format that reflects the specific 
demands of a health care workers’ duties. 
(7) NOTICE OF SAFE PATIENT HANDLING AND 
RIGHTS UNDER THIS ACT.—A requirement that each 
health care employer shall post a uniform notice in 
a form specified by the Secretary that— 
(A) explains the safe patient handling, mo-
bility, and injury prevention standard; 
(B) includes information regarding safe 
patient handling, mobility, and injury preven-
tion policies and training; 
(C) explains procedures to report patient 
handling-related injuries; and 
(D) explains health care workers’ rights 
under this Act, including any whistleblower pro-
tections. 
(8) ANNUAL EVALUATION.—A requirement that 
each health care employer shall conduct an annual 
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written evaluation of the implementation of the safe 
patient handling, mobility, and injury prevention 
program, including handling procedures, selection of 
technology, equipment, and engineering controls, as-
sessment of injuries, and new safe patient handling, 
mobility, and injury prevention technology and de-
vices that have been developed. The evaluation shall 
be conducted with the involvement of nurses, other 
health care workers, their representatives, and their 
collective bargaining agents, and their input shall be 
documented in the evaluation. Health care employers 
shall take corrective action as recommended in the 
written evaluation. 
(9) RIGHT TO REFUSE UNSAFE ASSIGNMENT.— 
A requirement that each health care employer shall 
provide procedures under which a health care worker 
or employee may refuse to perform the employee’s 
duties if the employee has a reasonable apprehension 
that performing such duties would violate the safe 
patient handling, mobility, and injury prevention 
standard, and would result in injury or impairment 
of health to the health care worker, other health 
care workers, or patients. Where practicable, the 
health care worker must have communicated the 
health or safety concern to the health care employer 
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and have not been able to obtain a correction of the 
violation. 
(c) INSPECTIONS.—The Secretary of Labor shall con-
duct unscheduled inspections under section 8 of the Occu-
pational Safety and Health Act of 1970 (29 U.S.C. 657) 
to ensure implementation of and compliance with the safe 
patient handling, mobility, and injury prevention stand-
ard. 
SEC. 3. APPLICATION OF SAFE PATIENT HANDLING, MOBIL-
ITY, AND INJURY PREVENTION STANDARD TO 
FACILITIES RECEIVING MEDICARE AND MED-
ICAID FUNDS. 
(a) IN GENERAL.—Section 1866 of the Social Secu-
rity Act (42 U.S.C. 1395cc) is amended— 
(1) in subsection (a)(1)(V), by inserting ‘‘and 
safe patient handling, mobility, and injury preven-
tion standard (as initially promulgated under section 
2 of the Nurse and Health Care Worker Protection 
Act of 2015)’’ before the period at the end; and 
(2) in subsection (b)(4)— 
(A) in subparagraph (A), by inserting 
‘‘and the safe patient handling, mobility, and 
injury prevention standard’’ after ‘‘Bloodborne 
Pathogens standard’’; and 
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(B) in subparagraph (B), inserting ‘‘or the 
safe patient handling, mobility, and injury pre-
vention standard’’ after ‘‘Bloodborne Pathogens 
standard’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to health care facilities 1 year 
after date of issuance of the final safe patient handling, 
mobility, and injury prevention standard required under 
section 2. 
SEC. 4. NONPREEMPTION. 
(a) EFFECT ON OTHER LAWS.—Nothing in this Act 
shall be construed to— 
(1) preempt any law, rule, or regulation of a 
State or political subdivision of a State, unless such 
law, rule, or regulation is in conflict with this Act 
or a regulation or order issued under this Act; 
(2) impair or diminish in any way the authority 
of any State to enact and enforce any law which pro-
vides equivalent or greater protections for employees 
engaging in conduct protected under this Act; 
(3) curtail or limit in any way the right of peo-
ple with disabilities under the Americans with Dis-
abilities Act (42 12101 et seq.) or section 504 of the 
Rehabilitation Act of 1973 (29 U.S.C. 794) to those 
reasonable modifications needed to receive equal ac-
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cess to health care, including the requirement that 
health care employees give priority consideration to 
the lifting, movement, or transfer needs and pref-
erences of people with disabilities; or 
(4) curtail or limit in any way consideration as 
an expenditure to acquire or modify equipment for 
use by or to benefit individuals with disabilities that 
is specified in section 44 of the Internal Revenue 
Code of 1986, which is available to eligible small 
businesses. 
(b) RIGHTS RETAINED BY HEALTH CARE WORK-
ERS.—Nothing in this Act shall be construed to diminish 
the rights, privileges, or remedies of any health care work-
er or employee under any Federal or State law, or under 
any collective bargaining agreement. 
SEC. 5. DEFINITIONS. 
For purposes of this Act: 
(1) DIRECT-CARE
REGISTERED
NURSE.—The 
term ‘‘direct-care registered nurse’’ means an indi-
vidual who has been granted a license by at least 
one State to practice as a registered nurse and who 
provides bedside care or outpatient services for one 
or more patients or residents. 
(2) EMPLOYEE.—The term ‘‘employee’’ means 
any individual employed by a health care employer, 
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to include health care workers, as well as employees 
who do not qualify as health care workers, including 
independent contractors. 
(3) EMPLOYMENT.—The term ‘‘employment’’ 
includes the provision of services under a contract or 
other arrangement. 
(4) HANDLING.—The term ‘‘handling’’ includes 
actions such as lifting, transferring, repositioning, 
mobilizing, moving, or any other action involving the 
physical movement, manipulation, or support of a 
patient by a health care worker, or any direct pa-
tient care action which presents a risk of musculo-
skeletal injury. 
(5) HEALTH
CARE
EMPLOYER.—The term 
‘‘health care employer’’ means an outpatient health 
care facility, hospital, nursing home, home health 
care agency, social assistance facility or program, 
hospice, federally qualified health center, nurse man-
aged health center, rural health clinic or rehabilita-
tive center, or any similar health care facility that 
employs direct-care registered nurses or other health 
care workers. 
(6) HEALTH CARE WORKER.—The term ‘‘health 
care worker’’ means an individual who has been as-
signed by a health care employer to engage in pa-
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tient handling, including direct-care registered 
nurses, independent contractors, or individuals who 
perform the duties of health care workers. 
Æ 
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