An economically and socially perceived drawback and a large concern to mandated nursing staff. The impact includes steep costs to implement additional nursing staff and the dilemma on how to deal with the fallout during nursing shortages. Funding allocation in nursing programs would need to be increased. Hospitals will be required to hire more nurses and increase their salaries and benefits to attract enough employees to fill the positions require. The state of California’s transformation in the mandated staffing ratio was a fruitful investment, but not all the states have the financial ability to do the same. The staffing ratio law might increase patient wait times in emergency departments. For example, due to the ratio law, nurses will not be able to see patients even though there are available beds. Additionally, this law is not prepared for a larger emergency situation happening within the hospital or the city that might require dramatic changes in nursing staff assignments. According to Illinois Hospital Study, “Rigid numerical staff-patient are inappropriate and inefficient” (2019), dealing with unique, patient, hospital units and could create nursing care inefficiency. While some critics of safe staff ratio claim that mandatory nurse-to-patient ratios burden hospitals with high operational costs, the majority of research shows the staff ratios are cost effective. High turnover rates and high levels of temporary staffing increase the average costs per discharge (cost of inpatient care, including administration) and overall operating costs. Safe staffing improves nurse performance and patient- mortality rate, reduces turnover rates, staffing costs and potential liabilities. A major recent study by University of Pennsylvania researchers covering more than 730 hospitals, showed that “Improvements within hospitals in work environments, nurse staffing, and educational composition of nurses coincide with improvements in quality of care and patient safety” [Douglas Sloan., Herbert Smith., Matthew McHugh., & Linda Aiken., 2018]. The link between nurse staffing ratios and patient safety has also been acknowledged by the Agency for Healthcare and Quality (AHRQ).