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Senate Finance Committee Democrats have issued a request for information on long-term care reforms, including nursing home ownership transparency, staffing and directing more public funding to resident care. Providers say they support several workforce and oversight proposals but oppose reinstating the 2024 federal staffing rule. The RFI seeks feedback; it is not a final policy.
Senate Finance Committee Democrats, led by Ranking Member Ron Wyden, have requested input on proposed long-term care reforms covering nursing home ownership, staffing and spending, while provider groups say they support several measures but oppose restoring the 2024 staffing rule. The request for information, or RFI, gathers feedback and does not itself establish new requirements.
The senators are seeking ways to improve ownership transparency and oversight, including restoring detailed disclosures to the Centers for Medicare and Medicaid Services (CMS), expanding beneficial ownership reporting to nursing homes and requiring CMS to examine an operator’s record before approving ownership changes. The RFI also asks about limiting private equity influence in nursing home operations.
On funding, the proposal would require facilities to direct a minimum share of Medicare and Medicaid payments to direct resident care, rather than management fees, rent paid to related entities or corporate profits. The senators are asking what percentage threshold would work and how federal policy could reflect state approaches. Massachusetts, New York and New Jersey have similar requirements, according to the RFI. It also proposes that states report how much Medicare funding reaches direct care workers.
Providers expressed support for parts of the agenda while drawing a line at a renewed staffing mandate. Saber Healthcare Group government affairs chief Zach Shamberg told Skilled Nursing News that the RFI contains “real common ground,” citing CNA training changes, expanded caregiver immigration pathways and stronger accountability. He said he opposes reinstating the 2024 rule. AHCA/NCAL chief executive Clif Porter said the organization is willing to work with lawmakers on policies supporting access, workforce and care quality.
Funding and Staffing at Issue
The proposals could affect how nursing homes report ownership, how regulators review incoming operators and how public reimbursement is used. A federal spending floor, if adopted, would set a minimum share of payments for direct resident care; the RFI has not specified that share. The questions matter to residents and families because they concern staffing, care quality and the financial accountability of facilities receiving public funds.
The staffing debate also reflects a practical divide: lawmakers are seeking stronger workforce standards, while providers argue that mandates must be matched with enough workers and funding. The RFI discusses training, wages and workforce pipelines alongside staffing requirements. Provider opposition to reinstating the 2024 rule signals that any future policy may face debate over how to raise staffing without imposing standards facilities say they cannot meet.
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The Dispute Over Staffing Rules
The RFI says the current federal staffing floor amounts to 18 minutes of direct care per resident per day and has not changed in nearly 40 years. The Biden administration’s 2024 rule would have required 3.48 hours of nursing care per resident per day and an RN on site around the clock. Congress blocked the rule, and the Trump administration rescinded it in December 2025, according to the source report.
Rather than simply restoring that rule, the RFI also raises other workforce options: updating the 75-hour CNA training standard, establishing portable credentials, developing competency-based training and expanding apprenticeships. It proposes that the HHS secretary review training standards every two to four years. The senators cite Illinois’ value-based Medicaid incentives as an example, saying staffing there rose 11% from 2022 to 2026—four times faster than the national average over that period.
“There is real common ground contained in this RFI.”
— Zach Shamberg, chief of government affairs at Saber Healthcare Group
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Key Details Still Under Review
The RFI is a request for feedback, not an enacted reform package. The source does not give a final direct-care spending threshold, a schedule for responding to submissions or details of which proposals might become legislation. It is also unclear how any new ownership disclosures or private-equity limits would be defined and enforced.
The staffing proposals remain contested. Providers’ objections are attributed positions, not findings about the effects of a future rule. The source report does not provide the full text of the RFI or the complete final quotation from Shamberg, which is cut off in the supplied excerpt. The senators’ next steps after collecting feedback are not specified.
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Feedback Before Policy Decisions
The immediate next step is for stakeholders to respond to the Senate Democrats’ RFI. Providers, residents’ advocates and other interested parties can weigh in on the proposed spending floor, ownership rules and workforce changes. The source report does not state a response deadline.
Any further action would depend on what lawmakers do after reviewing submissions. The proposals could be revised or pursued through legislation or other federal policy processes, but the source does not confirm a timetable or say which measures senators intend to advance first. For now, the reform ideas remain under discussion, with support for training and oversight alongside disagreement over mandatory staffing levels.
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Key Questions
What did Senate Finance Committee Democrats announce?
They issued a request for information seeking feedback on long-term care reforms, including nursing home ownership transparency, staffing and the use of public payments. The RFI is not itself a new law or rule.
What reforms do nursing home providers support?
Provider representatives cited CNA training updates, workforce recruitment, expanded caregiver immigration pathways and stronger accountability as areas for action. AHCA/NCAL said it is willing to work with lawmakers on policies supporting access, workforce development and care quality.
Do providers support bringing back the 2024 staffing rule?
No. Saber Healthcare Group’s Zach Shamberg said he opposes reinstating the rule. The source report says the 2024 rule was blocked by Congress and rescinded in December 2025.
Would the proposed spending floor set a specific amount?
Not yet. The RFI asks what percentage of Medicare and Medicaid reimbursement should go to direct resident care. The source does not identify a proposed final threshold.
What happens after the RFI?
Stakeholders are being asked to provide feedback. The source report does not specify a deadline or confirm which proposals lawmakers will pursue afterward.
Source: rss
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