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Mandatory staffing ratios

At Tufts Medical Center and Floating Hospital for Children, we work hard every day to provide the very best quality care for you and your family. 

This unwavering commitment to the health and safety of our patients is why we have joined with hundreds of other Massachusetts hospitals, nurses, medical societies, businesses and organizations to speak out against an upcoming ballot initiative. The ballot initiative concerns nurse staffing and at first glance it seems positive.  It would put into place rigid, government-mandated nurse-to-patient ratios throughout the state’s health care system. 

Here’s what the initiative would mean for you and for Tufts Medical Center and Floating Hospital for Children:

  • The ballot proposal puts the government in charge of care decisions.The ability of our caregivers to make critical, in the moment decisions for patients would be hindered.

  • It will be harder to access health care when and where you need it. Patients will experience longer emergency room wait times. Some patients could be turned away from the ED, regardless of the severity of their condition, if there are not enough nurses to satisfy the mandate.

  • The cost of implementing the bill would be an astronomical $1.3 billion. This will raise health insurance premiums, copays and taxes for everybody, without any evidence it will increase quality. The cost to Tufts Medical Center would be $20 million annually.

  • Every hospital will need to hire more registered nurses at a time when there is a nursing shortage. Tufts MC will have to hire 130+ Registered Nurses after less than 2 months of the law passing or be forced to close more than 60 hospital beds now used for patient care. We could no longer help approximately 20% of the patients that we do today. 

  • Because of the nurse shortage and the cost, all hospitals, including Tufts Medical Center and Floating Hospital, will need to make difficult decisions as to which services will continue and which will be cut or potentially, closed. Some community hospitals may close altogether.

Massachusetts has a reputation for having some of the best hospitals and healthcare in the country. In fact, quality reports show that Massachusetts hospitals rank better than hospitals in California, the only state to provide mandated ratios.  

Providing outstanding care requires constant assessment of patients by a clinical team and the ability to make quick decisions. Patient care is not something that can be mandated by the government and bogged down in rigid ratios. It requires flexibility, compassion and teamwork. 

Please look through the information on this website to learn more. We will be voting "NO" on Question 1 - the ballot initiative to mandate nursing ratio. We hope you'll join us in protecting patient care.


Deeb Salem, MD                                                                   Terry Hudson-Jinks, RN, MSN
Co-Interim CEO                                                                     Co-Interim CEO
Chair, Department of Medicine                                            Senior VP Patient Care Services

A person voting

We must defeat Ballot Question #1 this November

The nurse staffing initiative would have a devastating effect on every hospital’s ability to provide the kind of care you want and deserve.

Learn more about the initiative