This bill, known as the Safe Staffing Saves Lives Act, aims to significantly improve resident care in nursing facilities and skilled nursing facilities by establishing new minimum nurse staffing levels under the Medicare and Medicaid programs. Effective January 1, 2029, these facilities must provide a total of 4.1 hours of nursing care per resident per day , including specific allocations: 0.75 hours by a registered professional nurse, 0.55 hours by a licensed practical nurse, and 2.8 hours by a nurse aide. A crucial provision mandates that a registered professional nurse must be onsite and available 24 hours a day, 7 days a week . While the Secretary of Health and Human Services has the authority to establish even higher staffing levels, the bill also outlines a limited waiver process. Waivers, lasting no more than 180 days and capped at two consecutive periods, may be granted if a facility demonstrates an inability to comply, provided they submit detailed workforce and wage data. Importantly, waivers cannot be granted to special focus facilities or those with recent deficiencies causing resident harm or immediate jeopardy. To ensure compliance, the bill introduces robust enforcement mechanisms. Facilities failing to meet the new staffing requirements, even with a waiver, will face increased survey frequency , undergoing standard surveys every three months. Non-compliant facilities will also be subject to a prohibition on new admissions receiving Medicare or Medicaid payments for at least 180 days or until compliance is achieved. Furthermore, facilities found in non-compliance will be ineligible for Medicare's Skilled Nursing Facility Value-Based Purchasing Program and certain State directed payments under Medicaid. The bill also protects residents by prohibiting facilities from transferring or discharging them solely to meet staffing requirements. Facilities must prominently display and provide written notice to residents and their guardians if they are not meeting the minimum staffing standards, with this information also publicly available on the Nursing Home Compare website. Finally, the legislation requires time-stamped data on hours worked by certified employees to be included in facility staffing data starting January 1, 2027. The Secretary is also mandated to submit reports to Congress every five years, beginning in 2034, analyzing the impact of these staffing levels on resident safety, quality of care, deficiency rates, and staff retention, along with recommendations for future adjustments.