A bipartisan group of senators has introduced legislation meant to address the nursing shortage affecting healthcare providers and communities throughout the United States.

The Train More Nurses Act, introduced Wednesday by Sens. Mike Braun (R-IN), Susan Collins (R-ME) and Jacky Rosen (D-NV), directs the Health and Human Services and Labor secretaries to conduct a review of all nursing grant programs to find ways to increase faculty members at nursing schools, particularly in underserved areas. If passed as written, it also would increase pathways for licensed practical nurses to become registered nurses.

A shortage of nurses is not limited to the senators’ states, although Rosen noted that a recent analysis found that the state he represents, Nevada, is among the states with the fewest nurses per capita in the nation. 

The Train More Nurses Act comes at a critical time, with the proposal of a minimum staffing requirements that most nursing homes will be required to meet within the next three years 

If the draft rule released earlier this month by the Centers for Medicare & Medicaid Services is implemented as written, non-rural nursing homes will be required to provide a minimum of three hours per patient day of direct care — 0.55 hours of that care by a registered nurse and 2.45 hours by a nurse aide — within three years. Rural nursing homes will have five years to implement the overall hourly rate.

The mandated per-day levels are well below the 4.1 cumulative hours per day level that a CMS study recommended in 2001. But some 75% of nursing homes currently would need to add staffing to reach even the proposed compliance levels, CMS said. 

“There are simply no people to hire — especially nurses,” LeadingAge President and CEO Katie Smith Sloan said earlier this month. “The proposed rule requires that nursing homes hire additional staff. But where are they coming from?”

The staffing challenges are not limited to nursing homes. In a LeadingAge Workforce Snap Poll conducted earlier this year, 92% of its nursing home provider members reported a significant or severe workforce shortage, and 70% of assisted living providers said the same. The nursing home staffing mandate also is expected to affect other long-term care providers, such as assisted living communities, as nursing homes try to entice workers from other settings to meet the federal requirements.

Fitch Ratings’ latest monthly labor dashboard for senior living and care noted that providers across the sector still are recovering from labor challenges brought on by the COVID-19 pandemic. Staffing in continuing care retirement / life plan communities remains 7.4% below pre-pandemic levels, and the skilled nursing workforce is down 10% from pre-pandemic levels. Staffing in assisted living communities, by comparison, has rebounded to approximately 4% above pre-pandemic levels, Fitch said.

Introduction of the Train More Nurses Act follows the introduction of a separate bill this month that could affect nursing supply. The Primary Care and Health Workforce Act aims to arm community colleges and universities with $1.2 billion in grants to boost the number of students enrolled in accredited, two-year registered nursing programs. Within the next two years, the United States will need 200,000 to 450,000 additional nurses, according to recent estimates cited by Sen. Bernie Sanders (I-VT), a co-sponsor of that legislation.