Safe Staffing Saves Lives Act

Key Points

• Starting January 1, 2029, nursing homes participating in Medicare and Medicaid must provide a total minimum of 4.1 hours of nursing care per resident per day. This breaks down into 0.75 hours from a registered nurse, 0.55 hours from a licensed practical nurse, and 2.8 hours from a nurse aide.
• The bill requires a registered professional nurse to be physically present and available around the clock at every nursing facility, a significant upgrade from current rules that only require an RN for 8 hours a day in many facilities.
• Nursing homes that fail to meet the staffing minimums face strong enforcement, including denial of Medicare and Medicaid payments for new admissions, more frequent inspections (every 3 months instead of annually), and exclusion from value-based purchasing bonuses.
• Facilities out of compliance must post a visible notice at their entrance and provide written notice to every resident and their family. Compliance information will also be added to the government's Nursing Home Compare website so families can check staffing levels before choosing a facility.
• Nursing homes are explicitly banned from transferring or discharging current residents just to meet the new staffing ratios. Limited waivers of up to 180 days are available for facilities that genuinely cannot hire enough staff, but facilities with a history of harming residents are not eligible.
• Starting January 1, 2027, facilities must submit time-stamped staffing data showing the hours worked per day by each certified employee. HHS must report to Congress by 2034 and every 5 years after on how the staffing minimums affect resident safety, care quality, and nursing staff wages and retention.