Senate Democrats Revive Biden-Era Push for Federal Nursing Home Staffing Minimums as Advocates Call Policy ‘Outdated’
•February 12, 2026
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Why It Matters
Federal staffing standards could dramatically improve resident safety and alleviate caregiver strain, but the required workforce expansion and funding pose significant challenges for an already tight long‑term care market.
Key Takeaways
- •Bill restores 24/7 RN requirement, 3.5 care hours per resident.
- •Proponents estimate 13,000 lives saved annually.
- •LeadingAge warns $350M cost, 3,000 extra RN hires needed.
- •Nursing shortage and immigration limits hinder staffing mandate feasibility.
- •Bill funds inspections, redirects penalties to workforce recruitment.
Pulse Analysis
The Senate’s revived nursing‑home staffing bill reflects a broader push to codify the Biden administration’s 2024 CMS rule after courts questioned its statutory footing. By granting Congress explicit authority, the legislation seeks to lock in a 24‑hour registered nurse presence and a minimum of 3.5 caregiver hours per resident each day. Advocates argue that these metrics are directly linked to reduced medication errors, lower infection rates, and overall higher quality of life for seniors, positioning the policy as a public‑health safeguard.
Industry stakeholders, however, caution that the mandate collides with a persistent national nursing shortage projected to linger through 2038. LeadingAge estimates the requirement would demand more than 3,000 additional RNs, inflating operating costs by $350 million annually. The shortage is compounded by limited immigration pathways for foreign‑trained caregivers and competitive hiring pressures from hospitals and outpatient services. Consequently, many providers fear that strict staffing ratios could trigger closures or reduced admission capacity, especially for facilities already operating on thin Medicaid margins.
Beyond the immediate staffing calculus, the bill’s ancillary provisions aim to strengthen oversight and fund workforce pipelines. By allocating civil monetary penalties toward recruitment and retention programs, the legislation attempts to address the root causes of staffing gaps. Yet experts suggest that without parallel investments in nursing education, loan forgiveness, and immigration reform, the policy may only offer a partial fix. If enacted, the act could set a national benchmark, prompting states to align their own regulations and potentially reshaping the long‑term care landscape for the next decade.
Senate Democrats Revive Biden-Era Push for Federal Nursing Home Staffing Minimums as Advocates Call Policy ‘Outdated’
Seven Democratic senators introduced a bill Thursday to reinstate nursing home staffing standards similar to the now-repealed staffing mandate.
Led by Sen. Ron Wyden (D-Ore.) the top Democrat on the Senate Finance Committee, the Nurses Belong in Nursing Homes Act aims to strengthen nursing home staffing standards similar to the staffing rule pushed by the Biden administration.
The previous rule from the Centers for Medicare and Medicaid (CMS) was struck down in part due to questions over statutory authority and Congressional intent, and the new bill seeks to make a difference.
“The intent of the legislation is to grant clear authority to CMS to establish nursing home staffing standards. Given the court rulings, creating these standards will require an act of Congress,” Taylor Harvey, chief communications advisor and deputy policy director at U.S. Committee on Finance, told Skilled Nursing News.
The legislation would reinstate standards finalized in 2024 requiring a registered nurse on-site 24/7 and a minimum of 3.5 hours of care per resident per day. Supporters say the standards could save up to 13,000 lives annually and reduce incidents such as missed medications, lack of hygiene, and other signs of neglect.
Six Democratic senators joining Wyden in the introduction of the bill include Senators Andy Kim (D-N.J.), Cory Booker (D-N.J), Richard Blumenthal (D-Conn.), Chris Murphy (D-Conn.), Elizabeth Warren, (D-Mass.), and Ben Ray Lujan (D-N.M).
The senators argued that rolling back minimum staffing requirements has made nursing homes less safe for residents and more difficult workplaces for caregivers. They say adequate staffing is essential to preventing abuse, neglect, and poor health outcomes, and to ensuring seniors are treated with dignity.
“Republican actions and Trump’s backdoor deals with big executives mean your loved one’s nursing home will be less safe,” Sen. Wyden said in a press release referring to recent news that nursing home leaders donated to Trump’s campaign while urging permanent repeal of the previous federal staffing mandate. “It’s time to guarantee residents in nursing homes receive the quality of care they deserve and to lift the strain off long-term care workers reaching the breaking point,” Wyden noted in a press release.
Bill fails to address ‘very real barriers’
Nursing home lobbying groups have long argued that a staffing mandate would increase costs and force closures.
“Though we appreciate that Sen. Ron Wyden’s legislation contains more flexibility in mandated staffing than that of the now-repealed April 2024 finalized staffing rule, the core issue with these approaches must be addressed: workforce and funding,” Katie Smith Sloan, president and CEO, LeadingAge, the association of nonprofit providers of aging services, including nursing homes, said in a statement to Skilled Nursing News. “Aging services providers operate in a very challenging labor market, competing with a variety of employers across the health care industry that in many cases have access to far more resources.”
Meeting a 24/7 staffing requirement would require over 3,000 additional registered nurses (RNs) at a cost of $350 million annually, LeadingAge estimates.
Meanwhile, the U.S. already faces a significant nursing shortage projected to last through 2038, partly because nursing schools are not graduating enough RNs to fill current or future vacancies, and demand is rising as the population ages, Smith Sloan argued.
Moreover, she said that immigration policy changes have further strained the workforce by limiting the recruitment and retention of foreign-born caregivers, who make up a substantial share of long-term services.
The bill’s introduction comes as providers face reduced Medicaid funding, which already covers over 60% of nursing home residents but reimburses only about 80% of care costs, Smith Sloan’s statement noted.
“The bill stops well short of addressing the fundamental underlying issue: the need to expand the aging services workforce. We do not support it,” Smith Sloan said. “What we need are solutions to address the very real barriers that our nursing home members navigate in recruiting and retaining staff.”
Smith Sloan urged Congress and the administration to invest in building and sustaining the long-term care workforce by funding recruitment, training, and retention initiatives, addressing reimbursement shortfalls, and creating pathways for new caregivers to enter the field, including through long-overdue immigration reform.
For now, the bill aims to provide permanent funding for nursing home inspections, surveys, and enforcement to make sure nursing homes comply with staffing requirements. It calls for reinvesting civil monetary penalties (CMPs) imposed on nursing homes into supporting the recruitment and retention of nursing home workers. And, it is seeking to hold nursing homes accountable for investing taxpayer dollars in the frontline nursing home workforce.
Clif Porter, president and CEO of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), said the solutions in the bill are backward looking.
“Congress has already spoken on this issue when it deemed staffing mandates inappropriate and a threat to seniors’ access to care last year. It’s unfortunate that a minority of lawmakers are focused on outdated and failed policies of the past rather than common-sense and forward-thinking solutions,” Porter said. “Nursing homes have made significant strides recently, but to address our nation’s growing caregiver shortage, we need a collective effort in Washington to help us build the caregivers for tomorrow. We stand ready to work with policymakers from both parties on better ways to strengthen the nursing home workforce and quality care.”
Democratic senators backing the bill contend that repealing the previous rule benefited nursing home executives while leaving residents and workers vulnerable. They also argue that strong staffing requirements are supported by nearly all voters over the age of 50 and are critical to stabilizing and strengthening the long-term care workforce.
The post Senate Democrats Revive Biden-Era Push for Federal Nursing Home Staffing Minimums as Advocates Call Policy ‘Outdated’ appeared first on Skilled Nursing News.
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