Nurses Belong in Nursing Homes Act
Sponsored By: Senator Wyden, Ron [D-OR]
Introduced
Summary
A nationwide minimum nurse staffing standard would set required staffing levels and RN coverage for Medicare- and Medicaid-certified nursing homes to raise care consistency and oversight. It pairs staffing floors with studies, state reporting, and workforce investments to support hiring and training.
Show full summary
- Residents and families: Residents would have guaranteed licensed nursing available 24 hours a day and a minimum of at least 3.48 hours per resident per day of direct care.
- Nursing workforce: At least half of civil money penalties collected from facilities would be used for workforce support like recruitment, training, loan repayment, and career pathway programs, with limits to prevent funds going to related parties.
- States and regulators: States would submit annual reports on vacancy, turnover, wages, staffing hours, and resident quality; the Secretary would run periodic staffing studies and issue minimum-staffing rules based on those studies.
*Would authorize $50 million for the initial staffing study in FY2027 and $800 million annually for the CMS Survey and Certification program, increasing federal outlays.*
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 4 benefits, 0 costs, 0 mixed.
Minimum nursing home staffing rules
If enacted, nursing homes certified for Medicare or Medicaid would have to provide at least 3.48 hours of direct nursing care per resident each day. Registered nurses must be on duty at least 8 consecutive hours daily until 180 days after enactment and 24 hours a day, seven days a week on and after that 180-day date. The Secretary would run a staffing study within 2 years and every 4 years after, and write rules within one year after the first study and after later studies.
Make Medicaid managed care rules law
If enacted, two Medicaid managed care rules as they existed on May 10, 2024 (covering long-term services and supports and payment transparency) would be codified into statute. States, Medicaid managed care plans, and providers would have to follow those rules as law.
More funding for nursing oversight
If enacted, the bill would transfer $50 million in fiscal year 2027 to CMS for the nursing staffing study and would appropriate $800 million in fiscal year 2027 and each year after for CMS's Survey and Certification program. The money would remain available until spent to expand inspections, enforcement, and related staffing work.
Use nursing home fines for workforce
If enacted, States would have to use at least half of certain Medicaid civil money penalties collected each year for nursing facility workforce activities. States would also have to use Medicare civil money penalty amounts provided in a year for similar workforce activities. Allowed uses include training grants, career pathway projects, and student loan or tuition repayment when workers commit to at least 3 years of service within 10 years. States cannot give funds to related parties or use them to replace nurse aide training costs. States must report to the Secretary within one year and annually after; the Secretary must report to Congress within 180 days of receiving State reports.
Sponsors & CoSponsors
Sponsor
Wyden, Ron [D-OR]
OR • D
Cosponsors
Sen. Kim, Andy [D-NJ]
NJ • D
Sponsored 2/12/2026
Sen. Booker, Cory A. [D-NJ]
NJ • D
Sponsored 2/12/2026
Sen. Warren, Elizabeth [D-MA]
MA • D
Sponsored 2/12/2026
Sen. Luján, Ben Ray [D-NM]
NM • D
Sponsored 2/12/2026
Sen. Murphy, Christopher [D-CT]
CT • D
Sponsored 2/12/2026
Sen. Blumenthal, Richard [D-CT]
CT • D
Sponsored 2/12/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov