Requires a vote to adopt a nurse staffing plan by a hospital nurse staffing committee to be documented in the staffing plan. Directs a hospital to implement a hospital-wide nurse staffing plan that has been developed and adopted by the hospital nurse staffing committee or, if the committee has not adopted a plan, a hospital-wide nurse staffing plan that meets the statutory requirements. Directs that the statutory direct care registered nurse-to-patient staffing ratios constitute the nurse staffing plan for a unit if the hospital nurse staffing committee has not adopted a nurse staffing plan for the unit. Changes from four to five the number of patients that a direct care registered nurse may be assigned for a medical-surgical unit under the statutory staffing ratios. Allows a type C hospital to vary from the statutory direct care registered nurse-to-patient staffing ratios. Requires a unit manager to notify the cochairs of the hospital nurse staffing committee after each deviation from a nurse staffing plan. Establishes a maximum amount in civil penalties that may be imposed for violations of the hospital staffing requirements. Directs that all civil penalties collected shall be distributed to the local public health authorities. Prohibits the impositions of civil penalties for violations that occur before July 1, 2027. Modifies what constitutes a single violation for purposes of failure to comply with certain staffing ratios.