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S3886119th CongressWALLET

Nurses Belong in Nursing Homes Act

Sponsored By: Senator Wyden, Ron [D-OR]

Introduced

Summary

This bill would set a new federal floor for nurse staffing by requiring minimum nurse hours and guaranteed RN coverage in Medicare and Medicaid nursing facilities. It pairs those staffing rules with a mandated study, recurring funding for oversight, and rules to direct civil money penalties into workforce training and loan repayment.

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 2 benefits, 0 costs, 2 mixed.

New funding for nursing home oversight

If enacted, the bill would provide $800 million each year starting in fiscal year 2027 to fund CMS's Survey and Certification Program. The money would come from Medicare trust funds in proportions the Secretary decides. The funds would remain available until spent. The funding would support inspections, certification, and oversight of nursing homes and similar facilities.

Minimum nurse staffing in nursing homes

If enacted, nursing homes that take Medicare or Medicaid would need at least 3.48 hours of nursing care per resident each day. The bill would define hours per resident day (HPRD) as total hours worked by specified staff divided by total residents, as calculated by CMS. Facilities would need a registered nurse for at least 8 consecutive hours a day, seven days a week until the date that is 180 days after enactment. On or after that 180‑day date, facilities would have to provide RN coverage 24 hours a day, seven days a week.

Make Medicaid managed care rules law

If enacted, the bill would make two Medicaid managed‑care and payment‑transparency rules law as they were on May 10, 2024. That would make those managed‑care and payment‑transparency requirements enforceable for States, plans, providers, and enrollees. This could change how plans operate and how beneficiaries see costs and payments.

Penalty funds for nursing workforce programs

If enacted, the bill would require that at least 50% of certain Medicare and Medicaid nursing‑facility penalty funds be used in the year collected for workforce development. States could fund grants, career pathway programs, and student loan repayment or tuition if a worker commits to at least 3 years of service in a nursing facility within 10 years. States could not give these funds to related parties or use them to supplant nurse aide training costs. States must report annually, and HHS must report to Congress within 180 days after getting 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.

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