Photo of U.S. Capitol Dome
Photo credit: Getty Images
Photo of U.S. Capitol Dome
Photo credit: Getty Images

A new US House bill aims to bolster the country’s nursing home workforce with $400 million over each of the next four years. 

The Nursing Home Workforce Support and Expansion Act, introduced by Representative Steven Horsford (D-NV), would provide workforce grants to states, US territories and tribal governments based on their population of seniors and people with disabilities — targeting pay, benefits, education and retention improvements for nursing home workers. 

In announcing the bill, Horsford acknowledged the difficulties that providers face retaining workers. Most directly, the proposed legislation would address this by providing wage subsidies to help keep nursing home wages competitive with other healthcare sectors and competing industries. 

To supplement that, the grants also would fund student loan and tuition assistance, guarantee affordable childcare and subsidize transportation costs for workers. All of these measures would be required of any government entity that accepts grant funding.

Additionally, those government bodies would have the discretion to use grant funding to create emergency funds for nursing homes, subsidize paid leave for care workers and provide resources like interview clothes and legal assistance to lower the barriers of entry into the long-term care workforce. 

The bill defines who qualifies as an “eligible individual” to receive funding from the proposed grants — such as certified nurse aides, licensed practical nurses, social workers, and anyone in training for certification in those roles.

“Long-term care workers face low wages and challenging work conditions,” Horsford said. “I’ve seen the difference that high-quality care can make…. This legislation will invest in our care workers in nursing homes across the country so they can retain their skilled workers, while also expanding the workforce by attracting new individuals to the field.”

Unexpected allies

The proposed legislation comes as long-term care providers are staring down the impending arrival of a first-ever national nursing home staffing mandate and an already-existing staffing shortage during which nearly a quarter million nursing home workers left the sector between 2020 and 2023.

Providers and policymakers who are critics of the staffing rule from the Centers for Medicare & Medicaid Services have frequently called it an unfunded mandate and a clumsy, one-size-fits-all approach to improving care. Forecasts of the total cost for providers to implement the rule have varied, with CMS initially estimating around $4 billion and leading provider group the American Health Care Association estimating a roughly 70% higher $6.8 billion

While the Nevada congressman’s proposed legislation would make up for only a portion of that suggested price tag — a total of $1.6 billion spread between fiscal years 2025-2028 — top critics of the mandate have united behind the bill.

“The Nursing Home Workforce Support and Expansion Act exemplifies the support that the long term and post-acute care profession needs as we continue to face a caregiver shortage,” said Clif Porter, senior vice president of government relations at AHCA. “We thank Representative Horsford for his innovative and thoughtful approach to building policy that directly addresses the challenges of attracting and retaining passionate workers for the sector.”

Katie Smith Sloan, president and CEO of nonprofit association LeadingAge, shared that sentiment.

“Without staff, there is no care,” she said. “This bill … will get us one step closer to an America that values older adults and those who serve them.”

The SEIU, which represents many unionized long-term care workers, also threw its support behind the bill.