H.R. 8100 — Safe Staffing Saves Lives Act

This section establishes minimum nurse staffing requirements for Medicare skilled nursing facilities (SNFs), effective January 1, 2029 (limiting the prior general requirement for sufficient nursing care to services furnished before that date). SNFs must provide 4.1 hours of nursing care per resident per day—1.3 hours from licensed nurses (0.75 hours by registered nurses and 0.55 hours by licensed practical nurses) and 2.8 hours from nurse aides—with a registered nurse onsite 24 hours a day, 7 days a week. The Secretary may require higher levels, and states retain authority to do so. The Secretary may waive these requirements (and any higher levels) for up to 180 days (maximum of two consecutive waivers) if a facility demonstrates inability to comply due to local workforce conditions and submits supporting data on wages, benefits, turnover, and hiring efforts; waivers require notice to state ombudsman and protection systems and are ineligible for special focus facilities or those with recent harm/jeopardy deficiencies. For enforcement beginning January 1, 2029, noncompliant SNFs (regardless of waiver status) must undergo standard surveys at least every three months, and states must recommend remedies—with the Secretary authorized to prohibit new admissions or impose other actions.