Nurses Belong in Nursing Homes Act
Sponsored By: Senator Ron Wyden
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.
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
Ron Wyden
OR • D
Cosponsors
Andy Kim
NJ • D
Sponsored 2/12/2026
Cory Booker
NJ • D
Sponsored 2/12/2026
Elizabeth Warren
MA • D
Sponsored 2/12/2026
Sen. Luján, Ben Ray [D-NM]
NM • D
Sponsored 2/12/2026
Christopher Murphy
CT • D
Sponsored 2/12/2026
Richard Blumenthal
CT • D
Sponsored 2/12/2026
Roll Call Votes
No roll call votes available for this bill.
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