A nurse walking through a long hallway.
Credit: The Welfare & Medical Care/Getty Images Plus

The nation’s largest nursing home association is demanding that lawmakers withdraw a proposal in President Joe Biden’s infrastructure bill that would require long-term care facilities to have a registered nurse on staff 24 hours a day. 

The provision was recently added to the House version of the Build Back Better Act and requires skilled nursing facilities to have an RN on staff at all times starting Oct. 1, 2024. The proposal, however, does not mention how the 24-hour RN staffing rule would be funded, noted the American Health Care Association/National Center for Assisted Living. 

“We are ardent supporters of having a registered nurse on-staff in nursing homes 24 hours a day,” Clif Porter, AHCA/NCAL’s senior vice president of government relations, said in a statement Thursday. “However, the provision currently drafted in the House version of the budget reconciliation bill is an unfunded mandate that fails to offer any support to nursing homes.” 

With labor shortages already impacting operators, and in turn residents’ access to care, Porter added that, without funding and coordinated efforts to attract more caregivers to the industry, the provision could further limit access to care for millions.

“This is a complex issue with serious implications, and it requires proper deliberation through the traditional committee review process,” Porter said. “Lawmakers should remove this provision from the reconciliation package and give this matter the thorough consideration it deserves.” 

House Speaker Nancy Pelosi (D-CA) has been pushing for lawmakers to vote on the spending package this week, according to CNN. The House version also calls for about $415 million in nursing home worker training grants for states to support recruitment and retention efforts in post-acute and long-term care settings.