Newly introduced legislation in the Senate to mandate minimum staffing standards in nursing homes would seek to undo what the Trump Administration, bipartisan opposition in Congress, and the courts have already decided in killing off a regulatory proposal formulated by the Biden Administration that covers much of the same ground.

At issue is Sen. Ron Wyden’s (D-Ore.) new bill, the “Nurses Belong in Nursing Homes Act,” which aims to replicate much of the now-dead Biden-era staffing mandate by amending Medicare and Medicaid statutes to require minimum staffing standards, including an RN on duty 24/7 and a staffing floor of 3.48 total nursing hours per resident day provided by RNs, LPNs, and CNAs.

In addition to the nursing care components of the legislation, the bill would also:

• Require regular, evidence-based updates to federal staffing standards to reflect the changing needs of residents.

• Provide permanent funding for nursing home inspections, surveys, and enforcement to make sure nursing homes comply with staffing requirements.

• Reinvest civil money penalties imposed on nursing homes into supporting the recruitment and retention of nursing home workers.

• Hold nursing homes accountable for investing taxpayer dollars in the frontline nursing home workforce.

AHCA Chief Says Look Ahead, Not Behind

The reaction from skilled nursing sector leaders highlighted the need for solutions to the issue of staffing and not new attempts to promote rejected policies.

Clif Porter, president and CEO of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), said “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 It’s unfortunate that a minority of lawmakers are focused on outdated and failed policies of the past rather than common-sense and forward-thinking solutions.”

He pointed to a recent report that showed the sector has had success in hiring and retaining more workers and stressed the association’s commitment to its Caregivers for Tomorrow program.

“We stand ready to work with policymakers from both parties on better ways to strengthen the nursing home workforce and quality care,” Porter said. 

Parkinson Laments Bill for Missing the Point

Mark Parkinson, the former head of AHCA/NCAL and current CEO of Park Place Live, said the Wyden bill misses the mark, and will likely not find much support in Congress.

"It's unfortunate that after six years of discussing a minimum staffing rule, there are still politicians who won't face facts,” he said. “The volume of RNs needed to meet a 24/7 requirement don't exist in many parts of the country.  A targeted staffing approach of more infection control nurses, and more RNs on the shifts when they are actually needed is the solution.”

Parkinson added that “fortunately, there has been bipartisan opposition to impossible staffing requirements and I'm confident that this legislation will go nowhere."

Going, Going Gone

In early December 2025, the Dept. of Health and Human Services killed the staffing mandate regulation once and for all by repealing provisions of the “Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule.”

Before that action, Congress approved President Trump’s “One Big Beautiful Bill Act,” which was signed into law on July 4, 2025, and in part put minimum staffing requirements for nursing facilities on life support by banning the mandate for a decade. Federal court decisions in two separate jurisdictions also went against implementation of the mandate.

The Biden Administration staffing rule demanded that skilled nursing facilities participating in the Medicare and Medicaid programs provide residents with a minimum total of 3.48 hours of nursing care per day, including at least 0.55 hours from a RN per resident per day, and 2.45 hours from a nurse aide per resident per day. In addition, the rule required that each SNF have an RN onsite at all times.

These measures would have disproportionately burdened rural and underserved communities already grappling with critical health care workforce shortages, HHS said in announcing the end to the provisions.

In addition to Wyden, six other Democratic senators signed onto the bill as co-sponsors. They are Sens. Richard Blumenthal of Connecticut and Chris Murphy of Connecticut, Sen. Elizabeth Warren of Massachusetts, Sens. Andy Kim and Cory Booker of New Jersey, and Sen. Ben Ray Lujan of New Mexico.

Comments or questions? Please contact Patrick Connole at pconnole@parkplacelive.com.