National Nursing Shortage Reform and Patient Advocacy Act

National Nursing Shortage Reform and Patient Advocacy Act - Amends the Public Health Service Act to require hospitals to implement a staffing plan that includes a minimum direct care registered nurse-to-patient ratio by unit, adjustments above the minimum ratio under appropriate circumstances, and compliance with minimum licensed practical nurse staffing requirements. Requires the Secretary of Health and Human Services (HHS) to develop a national acuity tool to establish nurse staffing requirements above minimum ratios.

Directs the Secretary to adjust Medicare payments to hospitals to cover additional costs incurred in providing services to Medicare beneficiaries that are attributable to compliance with such ratios.

Gives a nurse the right to act as the patient's advocate, including by initiating action to improve health care or to change decisions or activities that are against the interests and wishes of the patient and by giving the patient an opportunity to make informed decision about health care before it is provided.

Authorizes a nurse to refuse to accept an assignment if it would violate minimum ratios under this Act or if the nurse is not prepared by education, training, or experience to fulfill the assignment without compromising the safety of any patient or jeopardizing the license of the nurse. Prohibits a hospital from: (1) taking specified actions against a nurse based on the nurse's refusal to accept an assignment for such a reason; or (2) discriminating against any patient, employee, or any other individual for good faith complaints or grievances relating to the care, services, or conditions of the hospital or of any affiliated or related facilities. Prohibits actions by hospitals to restrain such rights.

Includes stipends in the nurse workforce loan repayment and scholarship program. Expands the nurse retention grant program to authorize programs to implement nurse preceptorship and mentorship projects.