Sponsors (7)
The bill increases staffing standards, funding for oversight, and workforce supports to improve nursing home care and transparency, but does so by creating new mandatory funding streams, regulatory requirements, and funding restrictions that raise costs, strain recruitment (especially in rural areas), and reduce flexibility for states and providers.
Residents of nursing homes (seniors and people with chronic conditions) will get higher minimum direct nursing care — at least 3.48 hours per resident per day plus guaranteed RN coverage 24/7 — improving daily care, supervision, and likely reducing preventable harms.
Medicare beneficiaries, providers, and the public benefit from substantially increased and sustained federal funding for oversight and rule implementation (permanent $800M/year for Survey & Certification plus $50M for CMS program management to implement staffing rules), strengthening enforcement and program administration.
Current and prospective long-term care workers (RNs, LPNs/LVNs, CNAs, clinicians) gain more financial and training support — loan repayment/tuition assistance tied to service commitments, career-pathway programs, and grants — which should help recruit and retain staff and build career ladders.
Nursing facilities and state budgets face materially higher operating costs to meet new staffing and RN coverage requirements, which could force higher Medicaid/Medicare payments, higher taxes, cuts to other services, or provider cost-cutting that affects care availability.
Facilities in rural or underserved areas may struggle to recruit enough qualified nurses, risking service reductions or facility closures and reducing bed availability for seniors and others needing long-term care.
Some facilities may meet numeric staffing targets by relying more on lower-paid nurse aides (CNAs) rather than skilled RNs, which risks weaker clinical oversight despite hitting hours-per-resident metrics.
Based on analysis of 5 sections of legislative text.
Mandates 24-hour licensed nursing and at least 3.48 HPRD in nursing homes, redirects civil money penalties to workforce uses, codifies two regs, and funds Survey & Certification $800M/yr.
Official title: Establish total nurse staffing hours per resident day, to require 24-hour use of registered professional nurses in nursing homes, and for other purposes.
Introduced February 12, 2026 by Ronald Lee Wyden · Last progress February 12, 2026
Requires nursing homes to provide 24-hour licensed nursing services and a minimum of 3.48 hours per resident day (HPRD) of direct nursing care supplied by RNs, LPNs/LVNs, or CNAs, with the RN requirement effective 180 days after enactment. Redirects and limits uses of nursing-facility civil monetary penalties toward workforce development programs, mandates reporting, codifies two existing long-term care payment/transparency regulations into statute, and permanently appropriates $800 million annually (from Medicare trust funds) to fund the HHS Survey and Certification Program.