Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009

Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009 - Amends the Public Health Service Act to require hospitals to implement staffing plans that meet specified ratios for direct care registered nurse-to-patient staffing levels for each unit and other requirements, including for receiving input from nurses. Allows the Secretary of Health and Human Services to further limit such ratios as needed to ensure public safety and to establish ratios for units not specified. Provides an exception to such staffing requirements for a declared state of emergency. Requires hospitals to provide the Secretary with their staffing plan and annual updates. Requires the Secretary to conduct audits to ensure the implementation of adequate staffing plans.

Requires the Secretary: (1) acting through the Director of the Agency for Healthcare Research and Quality (AHRQ), to complete a study of licensed practical nurse staffing and its effects on patient care in hospitals; and (2) to establish requirements for hospitals based on the outcome of the study.

Requires the Secretary to adjust payments to cover additional Medicare costs that are attributable to this Act. Requires the Medicare Payment Advisory Commission to submit to Congress and the Secretary a report estimating total costs and savings attributable to compliance with nurse staffing requirements.

Provides nurses with the right to refuse to accept assignments that would violate staffing requirements or for which they are not prepared. Prohibits retaliation by hospitals for such refusals or for reporting violations of staffing requirements.