Sponsors (7)
The bill would substantially raise staffing standards, oversight, and workforce supports to improve nursing home care and regulatory certainty, but it does so by shifting significant costs and administrative burdens to providers, states, and Medicare/Medicaid funding streams—creating a trade-off between better resident safety and fiscal/operational strain on the long-term care system.
Nursing home residents (including Medicare and Medicaid beneficiaries) would get more direct care and 24-hour licensed nursing/RN coverage—minimum combined nursing care time and overnight RN coverage improve clinical responsiveness and safety.
Medicare and Medicaid beneficiaries would receive more consistent oversight and clearer statutory protections because survey/certification funding is stabilized and key Medicaid rules are codified—improving enforcement and quality monitoring.
Nursing facility staff and prospective hires (RNs, LPNs/LVNs, CNAs) gain stronger workforce supports—formal consultation in staffing rulemaking, student-loan repayment/tuition assistance, and training grants that help recruit and retain staff.
Nursing homes, states, and taxpayers face materially higher costs to meet staffing mandates—raising operating and Medicaid reimbursement expenses that could translate into higher prices, reduced services, or facility closures and strain state budgets.
Shifting $800 million annually to fund survey/certification from Medicare trust funds could pressure trust fund solvency or crowd out other Medicare priorities, potentially affecting benefits or program sustainability.
The 180-day compliance timeline for new staffing requirements may be too short for many facilities to recruit and credential enough RNs and aides, risking noncompliance, emergency staffing measures, or disruptions to resident care.
Based on analysis of 5 sections of legislative text.
Requires 24-hour licensed nursing and a minimum of 3.48 HPRD in Medicare/Medicaid nursing facilities, mandates studies/rules, and funds survey/certification $800M/year starting FY2027.
Introduced February 12, 2026 by Ronald Lee Wyden · Last progress February 12, 2026
Requires Medicare- and Medicaid-certified nursing facilities to provide 24-hour licensed nursing services and meet a minimum staffing level of at least 3.48 hours per resident day (HPRD) of nursing care delivered by RNs, LPNs/LVNs, or CNAs, with the requirement effective 180 days after enactment. Directs HHS to conduct studies and issue staffing recommendations, permanently appropriates $800 million annually (starting FY2027) for the Medicare Survey and Certification Program, revises how certain civil penalty funds may be used to support workforce development, and codifies two existing CMS regulatory provisions into statute. Imposes reporting and use rules for workforce funding distributed to states, prohibits awarding some funds to entities that are related parties to nursing facilities, and adds new administrative duties and rulemaking authority for the Secretary to set and update minimum staffing standards.