Safe Staffing Saves Lives Act
Sponsored By: Representative Doggett, Lloyd [D-TX-37]
Introduced
Summary
Sets federal minimum nurse staffing levels for Medicare and Medicaid nursing facilities. The Safe Staffing Saves Lives Act would require 24-hour licensed nursing services and a daily minimum of 4.1 total nursing hours per resident, and it would require a registered nurse (RN) on-site and available 24 hours a day, 7 days a week.
Show full summary
- Residents and families: Nursing homes would have to provide at least 4.1 total nursing hours per resident each day and a 24/7 RN would be on-site. This aims to raise the baseline level of hands-on care.
- Nursing staff and workforce: The bill defines an allocation of those hours, including 1.3 hours of licensed nursing per resident per day and 2.8 hours from nurse aides, and it lets the Secretary set higher minimums to address staffing needs.
- Facilities, states, and transparency: Facilities could request temporary waivers up to 180 days with workforce and turnover data. Noncompliance can trigger payment denials and faster surveys, and Nursing Home Compare must show whether each facility meets the standard or has an active waiver.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 3 benefits, 1 costs, 1 mixed.
Minimum nurse staffing for nursing homes
If enacted, nursing homes paid by Medicare or Medicaid would need to provide at least 4.1 nursing hours per resident each day. That would include 0.75 hours from an RN, 0.55 hours from an LPN, and 2.8 hours from nurse aides. A registered nurse would have to be onsite and available 24 hours a day. These rules would start January 1, 2029, and the Secretary could set higher minimums.
Payment penalties for noncompliant nursing homes
If enacted, States would have to stop Medicaid payments for people admitted after a finding that a nursing home fails the staffing rules. The Secretary could stop Medicare or Medicaid payments from the finding date until the later of 180 days or when the home complies. Noncompliant homes would also be excluded from certain value-based payments and subject to quicker surveys. These enforcement rules would start January 1, 2029.
Temporary waivers for nursing staffing
If enacted, States and the federal government could grant temporary waivers of the staffing rules for up to 180 days when a facility shows it cannot reasonably comply. Facilities seeking a waiver would have to give workforce and wage data, turnover rates, proof of added benefits, and hiring commitments. Waivers would be limited to two in a row and would not be allowed for facilities with recent serious harm or in the Special Focus Facility program. States must notify ombudsmen and protection-and-advocacy systems. The Secretary could review waivers and take over a State's waiver power. These rules would start January 1, 2029.
Resident notice and transfer protections
If enacted, nursing homes that do not meet the staffing rules would have to post a clear notice at the entrance and give a written copy to each resident and appropriate family members. Public websites would show whether a home meets the staffing rules or has a waiver. Homes could not transfer or discharge a resident solely to meet staffing rules. These protections would start January 1, 2029.
Per-shift staff hours reporting
If enacted, starting January 1, 2027, nursing homes would have to collect time-stamped data showing the hours each certified staff member worked each day in each staff category. That more detailed data would be used for public reporting and enforcement. The rule is a transparency and oversight change rather than a benefit payment.
Sponsors & CoSponsors
Sponsor
Doggett, Lloyd [D-TX-37]
TX • D
Cosponsors
Schakowsky
IL • D
Sponsored 3/26/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov