Just over one month after the introduction of a Senate bill with a similar focus, Representatives Lloyd Doggett (D-TX) and Jan Schakowski (D-IL) on March 26, 2026, introduced the Safe Staffing Saves Lives Act to establish minimum staffing standards in nursing homes.

In contrast to the Senate’s Nurses Belong in Nursing Homes Act (S. 3886), introduced on February 12, the House bill contains significantly more provisions.

In addition to a requirement for 24 hours per day, 7 days per week of registered nurse (RN) staffing, the bill would require nursing homes to provide 4.1 hours per resident, per day (HPRD) of total nurse staffing. This 4.1 HPRD would include at least 1.3 HPRD of “direct licensed nursing care” divided between 0.75 HPRD of RN staffing and 0.55 HPRD of licensed practical nurse (LPN) staffing, and 2.8 HPRD of certified nursing assistant (CNA) hours.

These requirements are higher than both the Senate bill introduced in February 2026 and the regulatory requirements repealed in December 2025.

The House bill further establishes penalties for failure to meet staffing standards including increased surveys and exclusion from the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) program and state directed payment programs, among other more traditional penalties like denials of payment.

The bill includes provisions for a waiver and requirements for notifications of noncompliance similar to the parameters outlined in the Centers for Medicare & Medicaid Services (CMS) minimum staffing standards rule.

If passed, the standards in this bill would be required to be implemented January 2029.

LeadingAge does not support this bill. Workforce shortages and inadequate Medicaid reimbursement remain critical challenges for our members as they work tirelessly to provide quality care to nursing home residents. LeadingAge will be working with Hill staff to address these issues as we monitor the progress of this bill.