Sponsors (7)
This is not an official government website.
Copyright © 2026 PLEJ LC. All rights reserved.
Requires 24-hour licensed nursing coverage in Medicare and Medicaid nursing facilities, sets a minimum staffing floor of 3.48 hours per resident per day (HPRD) delivered by RNs, LPN/LVNs, and CNAs with an RN on duty 24 hours, and makes that staffing rule effective 180 days after enactment. Directs recurring federally led studies of nursing home staffing and safety, requires HHS to issue implementing regulations, creates new annual and one-time federal funding streams to support inspection and enforcement, and directs states to use certain civil money penalty funds for workforce recruitment, training, career pathways, and loan repayment while imposing reporting and prohibition rules on those uses. Also permanently appropriates funds for the federal Survey and Certification Program beginning in FY2027, transfers one-time funds to support CMS implementation, and converts two specific long-term services/payment-transparency regulations into statutory law as of enactment.
The bill aims to raise nursing home staffing, strengthen enforcement, and invest in workforce development to improve care quality, but it does so by locking in regulatory text and redirecting/adding federal dollars—raising provider costs and Medicare trust‑fund pressures while reducing some state flexibility and risking access problems in hard-to-staff areas.
Medicare and Medicaid residents (largely seniors and people with disabilities) will get higher baseline nursing coverage because facilities must meet minimum staffing (3.48 HPRD) and 24‑hour RN availability, improving day-to-day care quality and safety.
Hospitals and nursing facilities — and the patients they serve — will benefit from stronger, better-funded enforcement and more consistent inspections/certifications, supporting higher quality and compliance with Medicare standards.
Health care workers in nursing and skilled nursing facilities may face lower education debt and stronger career pipelines through loan repayment/tuition assistance and state grants for training and career-pathway programs, helping recruitment and retention.
Medicare solvency and federal budgets face increased pressure because the bill shifts substantial recurring dollars from Medicare trust funds (an $800M annual transfer plus a $50M HI transfer), which could reduce benefit funding or increase taxpayer costs over time.
Nursing facilities will face higher operating costs to meet new minimum staffing and 24‑hour RN requirements, which could lead to higher Medicaid/Medicare payments, increased facility charges, or financial strain on providers.
Rural and hard-to-staff facilities may struggle to recruit required RNs/LPNs/CNAs, risking staffing waivers, facility closures, or reduced bed capacity and access to long‑term care in some communities.
Introduced February 12, 2026 by Ronald Lee Wyden · Last progress February 12, 2026