SB 527 - This act provides that hospitals and ambulatory surgical centers implement an acuity-based patient classification system in order to ensure adequate nurse to patient ratios. This act specifically enumerates minimum direct-care registered nurse-to-patient ratios for various units within a hospital or ambulatory surgical center. The Department of Health and Senior Services shall have the powers and duties to promulgate rules and regulations necessary to implement the ratios. As a condition of licensing, each hospital or ambulatory surgical center shall submit annually to the department a prospective staffing plan which is sufficient to meet the specified ratios. This act also provides that hospitals and ambulatory surgical centers may be fined twenty-five thousand dollars for failing to adhere to a daily written nurse staffing plan as prescribed in Section 197.288, RSMo. The fines collected will be placed in the Health Initiatives Fund. ADRIANE CROUSE