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 
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) 
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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 2009)’’ before the period at the end; and 
(2) in subsection (b)(4)— 
(A) in subparagraph (A), inserting ‘‘and 
the safe patient handling, mobility, and injury 
prevention standard’’ after ‘‘Bloodborne Patho-
gens standard’’; and 
(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 
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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; or 
(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. 
(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 
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