Synopsis As Introduced Creates the Nursing Care and Quality Improvement Act. Provides that each hospital shall implement a staffing plan that (i) provides adequate, appropriate, and quality delivery of health care services, (ii) protects patient safety, and (iii) is consistent with the requirements of the Act. Sets forth the minimum direct care registered nurse-to-patient ratios required in a unit of a hospital during each shift in that unit. Sets forth development and reevaluation requirements for the staffing plan. Prohibits a hospital from discharging, discriminating against, or retaliating against (i) a nurse in any manner with respect to any aspect of employment based on the nurse's refusal of a work assignment under certain conditions or (ii) a nurse or any individual, who, in good faith, reports a violation of the Act, initiates, cooperates, or otherwise participates in an investigation or proceeding under the Act, or informs or discusses with other individuals or with representatives of hospital employees a violation or suspected violation of the Act. Sets forth penalties for violation of the Act.