{
  "legislationId": "119_HR_8100",
  "lastUpdate": "2026-04-01T11:18:53.556Z",
  "history": [
    {
      "timestamp": "2026-04-01T11:18:53.556Z",
      "source_url": "https://www.congress.gov/119/bills/hr8100/BILLS-119hr8100ih.htm",
      "model": "gemini-flash-lite-latest",
      "prompt_sent": "\nROLE: Fact Checker.\nZADANIE: Porównaj SOURCE (oryginał) i SUMMARY (streszczenie przygotowane przez inne AI).\n\nTwoim celem jest wykrycie \"ZMYŚLONYCH KONKRETÓW\" (Fabricated Entities) w SUMMARY.\n\nSOURCE:\n[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 8100 Introduced in House (IH)] <DOC> 119th CONGRESS 2d Session H. R. 8100 To amend titles XI, XVIII, and XIX of the Social Security Act with respect to minimum staffing levels in skilled nursing facilities and nursing facilities under the Medicare and Medicaid programs. _______________________________________________________________________ IN THE HOUSE OF REPRESENTATIVES March 26, 2026 Mr. Doggett (for himself and Ms. Schakowsky) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned _______________________________________________________________________ A BILL To amend titles XI, XVIII, and XIX of the Social Security Act with respect to minimum staffing levels in skilled nursing facilities and nursing facilities under the Medicare and Medicaid programs. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Safe Staffing Saves Lives Act''. SEC. 2. MINIMUM STAFFING LEVELS IN NURSING FACILITIES AND SKILLED NURSING FACILITIES. (a) Establishing Minimum Staffing Levels for Registered Nurses in Nursing Facilities and Skilled Nursing Facilities.-- (1) Medicare.-- (A) In general.--Section 1819(b)(4) of the Social Security Act (42 U.S.C. 1395i-3(b)(4)) is amended-- (i) in subparagraph (C)-- (I) in the subparagraph heading, by inserting ``before 2029'' after ``Required nursing care''; and (II) in clause (i), by striking ``Except as provided in clause (ii)'' and inserting ``With respect to skilled nursing facility services furnished before January 1, 2029, except as provided in clause (ii)''; and (ii) by adding at the end the following new subparagraph: ``(D) Required nursing care beginning in 2029.-- ``(i) In general.--Subject to clause (iii), beginning January 1, 2029, a skilled nursing facility-- ``(I) must provide 24-hour licensed nursing services which are sufficient to meet the nursing needs of its residents; ``(II) must provide for minimum nurse staffing levels with respect to each day; ``(III) must ensure that, in carrying out subclauses (I) and (II), a total minimum of 4.1 hours of nursing care is provided per resident per day, with-- ``(aa) 1.3 hours of care of such total minimum consisting of licensed nursing services, with 0.75 hours of such care provided by a registered professional nurse and 0.55 hours of such care provided by a licensed practical nurse; and ``(bb) 2.8 hours of care of such total minimum provided by a nurse aide (as defined in paragraph (5)(F)); and ``(IV) must ensure that a registered professional nurse is onsite and available to furnish licensed nursing services 24 hours a day, 7 days a week. ``(ii) Secretarial authority to establish higher minimum nurse staffing levels.--The Secretary may establish and require skilled nursing facilities to provide for minimum nurse staffing levels that are higher than the levels required under this subparagraph. ``(iii) Waiver.-- ``(I) In general.--Subject to the succeeding provisions of this clause, the Secretary may waive the requirements under clause (i) (and such additional requirements as may be established under clause (ii)) with respect to a skilled nursing facility for a period of not more than 180 days if-- ``(aa) the facility demonstrates to the satisfaction of the Secretary that the facility cannot reasonably comply with such requirements; ``(bb) the facility provides to the Secretary such information as the Secretary determines necessary to support a determination under item (aa), which shall include information with respect to-- ``(AA) workforce and wage data for the area in which the facility is located; ``(BB) additional employee benefits offered by the facility; ``(CC) the annual rate of turnover with respect to nursing staff at the facility, disaggregated by category of staff; and ``(DD) the facility's demonstrated commitment to hiring nursing staff; and ``(cc) the Secretary provides notice of the waiver to the State long-term care ombudsman (established under section 307(a)(12) of the Older Americans Act of 1965) and the protection and advocacy system in the State for the mentally ill and the mentally retarded. ``(II) Ineligibility.--The Secretary may not grant a waiver under this clause to a skilled nursing facility that-- ``(aa) has been identified under the special focus facility program under subsection (f)(8) as having substantially failed to meet an applicable requirement of this Act; or ``(bb) during the 1-year period preceding a request for such a waiver, was found to have deficiencies that-- ``(AA) resulted in harm to a resident; or ``(BB) immediately jeopardized the health or safety of its residents. ``(III) Limitations.--A skilled nursing facility may not receive more than 2 consecutive waivers under this clause. ``(iv) Rule of construction regarding state authority to establish higher minimum nurse staffing levels.--Nothing in this subparagraph may be construed as preventing a State from establishing or requiring skilled nursing facilities in the State to provide for minimum nurse staffing levels that are higher than the levels required under this subparagraph.''. (B) Enforcement.-- (i) Increased survey frequency.--Section 1819(g)(2)(A)(iii) of the Social Security Act (42 U.S.C. 1395i-3(g)(2)(A)(iii)) is amended-- (I) in subclause (I), by striking ``Each'' and inserting ``Subject to subclause (III), each''; and (II) by adding at the end the following new subclause: ``(III) Staffing level surveys.-- Beginning January 1, 2029, in the case of a skilled nursing facility that is found not to meet the minimum staffing requirements of subsection (b)(4)(D) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subsection), such facility shall be subject to a standard survey not later than 3 months after the date of the previous standard survey conducted under this subparagraph.''. (ii) Prohibition on admission of new residents; audits.--Section 1819(h) of the Social Security Act (42 U.S.C. 1395i-3(h)) is amended-- (I) in paragraph (1), by striking ``If a State finds, on the basis of a standard'' and inserting ``Subject to paragraph (7), if a State finds, on the basis of a standard''; (II) in paragraph (2), by striking ``With respect to'' and inserting ``Subject to paragraph (7), with respect to''; and (III) by adding at the end the following new paragraph: ``(7) Special rule with respect to minimum nurse staffing requirements.-- ``(A) In general.--Beginning January 1, 2029, if a State finds, on the basis of a standard, extended, or partial extended survey under subsection (g)(2) or otherwise, that a skilled nursing facility does not meet the minimum staffing requirements of subsection (b)(4)(D) (without regard to whether such facility has in effect a waiver of such requirements under clause (iii) of such subsection), the State shall recommend to the Secretary that the Secretary take such actions as described in subparagraph (B). ``(B) Secretarial authority.--Beginning January 1, 2029, with respect to any skilled nursing facility in a State, if the Secretary finds, or pursuant to a recommendation of the State under subparagraph (A) finds, that a skilled nursing facility does not meet the minimum staffing requirements of subsection (b)(4)(D) (without regard to whether such facility has in effect a waiver of such requirements under clause (iii) of such subsection), the Secretary shall deny any further payments under this title with respect to any individuals entitled to benefits under this title admitted to the facility for the period beginning on the effective date of the finding and ending on the later of-- ``(i) the date that is 180 days after such effective date; or ``(ii) the date on which the Secretary determines that the facility has come into compliance with such minimum staffing requirements. ``(C) Relationship to other enforcement mechanisms.--The remedies provided under this paragraph are in addition to those otherwise available under this subsection and shall not be construed as limiting such other remedies.''. (iii) Ineligibility for snf vbp program.-- Section 1888(h)(1)(C) of the Social Security Act (42 U.S.C. 1395yy(h)(1)(C)) is amended-- (I) by redesignating clauses (i) and (ii) as subclauses (I) and (II), respectively, and adjusting the margins accordingly; (II) by striking ``With respect'' and inserting the following: ``(i) In general.--With respect''; and (III) by adding at the end the following new clause: ``(ii) Exclusion of facilities out of compliance with minimum staffing standards.-- With respect to payments for services furnished on or after January 1, 2029, this subsection shall not apply to a facility that does not meet the minimum staffing requirements of subsection (b)(4)(D) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subsection).''. (C) Application to transfer and discharge rights.-- Section 1819(c)(2)(A) of the Social Security Act (42 U.S.C. 1395i-3(c)(2)(A)) is amended by adding at the end of the flush-left text the following new sentence: ``Beginning January 1, 2029, a skilled nursing facility may not transfer or discharge a resident solely for purposes of meeting the minimum staffing requirements under subsection (b)(4)(D).''. (D) Notice of noncompliance to residents and guardians.-- (i) In general.--Section 1819(c) of the Social Security Act (42 U.S.C. 1395i-3(c)) is amended by adding at the end the following new paragraph: ``(7) Notice in the case of noncompliance with minimum staffing standards.--Beginning January 1, 2029, in the case of a skilled nursing facility that does not meet the minimum staffing requirements of subsection (b)(4)(D) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subsection), such facility shall-- ``(A) prominently display at the entrance to the facility a notice that such facility does not meet such standards (and has in effect such a waiver, if applicable); and ``(B) provide each resident of the facility (or, where appropriate, the guardians or legal representatives of such residents) and members of their immediate families with a written copy of such notice.''. (ii) Nursing home compare website.--Section 1819(i)(1)(A)(i) of the Social Security Act (42 U.S.C. 1395i-3(i)(1)(A)(i)) is amended by inserting ``(and, beginning January 1, 2029, information on whether the facility meets the minimum staffing requirements of subsection (b)(4)(D) (or has in effect a waiver of such requirements under clause (iii) of such subsection)'' after ``staffing turnover and tenure''. (E) Conforming amendment.--Section 1819(f)(2)(B)(iii)(I)(a) of the Social Security Act (42 U.S.C. 1395i-3(f)(2)(B)(iii)(I)(a)) is amended by inserting ``or subsection (b)(4)(D)(iii)'' after ``subsection (b)(4)(C)(ii)(II)''. (2) Medicaid.-- (A) In general.--Section 1919(b)(4) of the Social Security Act (42 U.S.C. 1396r(b)(4)) is amended-- (i) in subparagraph (C)(i)-- (I) in the clause heading, by inserting ``before 2029'' after ``General requirements''; and (II) in the matter preceding subclause (I), by inserting ``and before January 1, 2029,'' after ``With respect to nursing facility services provided on or after October 1, 1990,''; and (ii) by adding at the end the following new subparagraph: ``(D) General requirements beginning in 2029.-- ``(i) In general.--Subject to clause (iii), beginning January 1, 2029, a nursing facility-- ``(I) must provide 24-hour licensed nursing services which are sufficient to meet the nursing needs of its residents; ``(II) must provide for minimum nurse staffing levels with respect to each day; ``(III) must ensure that, in carrying out subclauses (I) and (II), a total minimum of 4.1 hours of nursing care is provided per resident per day, with-- ``(aa) 1.3 hours of care of such total minimum consisting of licensed nursing services, with 0.75 hours of such care provided by a registered professional nurse and 0.55 hours of such care provided by a licensed practical nurse; and ``(bb) 2.8 hours of care of such total minimum provided by a nurse aide (as defined in paragraph (5)(F)); and ``(IV) must ensure that a registered professional nurse is onsite and available to furnish licensed nursing services 24 hours a day, 7 days a week. ``(ii) Secretarial authority to establish higher minimum nurse staffing levels.--The Secretary may establish and require nursing facilities to provide for minimum nurse staffing levels that are higher than the levels required under this subparagraph. ``(iii) Waiver.-- ``(I) In general.--Subject to the succeeding provisions of this clause, a State may waive the requirements under clause (i) (and such additional requirements as may be established under clause (ii)) with respect to a nursing facility for a period of not more than 180 days if-- ``(aa) the facility demonstrates to the satisfaction of the State that the facility cannot reasonably comply with such requirements; ``(bb) the facility provides to the State such information as the State determines necessary to support a determination under item (aa), which shall include information with respect to-- ``(AA) workforce and wage data for the area in which the facility is located; ``(BB) additional employee benefits offered by the facility; ``(CC) the annual rate of turnover with respect to nursing staff at the facility, disaggregated by category of staff; and ``(DD) the facility's demonstrated commitment to hiring nursing staff; and ``(cc) the State agency granting a waiver of such requirements provides notice of the waiver to the State long- term care ombudsman (established under section 307(a)(12) of the Older Americans Act of 1965) and the protection and advocacy system in the State for the mentally ill and the mentally retarded. A waiver under this clause shall be subject to the review of the Secretary and subject to clause (iv) shall be accepted by the Secretary for purposes of this title to the same extent as is the State's certification of the facility. In granting or renewing a waiver, a State may require the facility to use other qualified, licensed personnel. ``(II) Ineligibility.--The State may not grant a waiver under this clause to a skilled nursing facility that-- ``(aa) has been identified under the special focus facility program under subsection (f)(10) as having substantially failed to meet applicable requirements of this Act; or ``(bb) during the 1-year period preceding a request for such a waiver, was found to have deficiencies that-- ``(AA) resulted in harm to a resident; or ``(BB) immediately jeopardized the health or safety of its residents. ``(III) Limitations.--A nursing facility may not receive more than 2 consecutive waivers under this clause. ``(iv) Assumption of waiver authority by secretary.--If the Secretary determines that a State has shown a clear pattern and practice of allowing waivers in the absence of diligent efforts by facilities to meet the staffing requirements, the Secretary shall assume and exercise the authority of the State to grant waivers. ``(v) Rule of construction regarding state authority to establish higher minimum nurse staffing levels.--Nothing in this subparagraph may be construed as preventing a State from establishing or requiring skilled nursing facilities in the State to provide for minimum nurse staffing levels that are higher than the levels required under this subparagraph.''. (B) Enforcement.-- (i) Increased survey frequency.--Section 1919(g)(2)(A)(iii) of the Social Security Act (42 U.S.C. 1396r(g)(2)(A)(iii)) is amended-- (I) in subclause (I), by striking ``Each'' and inserting ``Subject to subclause (III), each''; and (II) by adding at the end the following new subclause: ``(III) Staffing level surveys.-- Beginning January 1, 2029, in the case of a nursing facility that is found not to meet the minimum staffing requirements of subsection (b)(4)(D) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subsection), such facility shall be subject to a standard survey not later than 3 months after the date of the previous standard survey conducted under this subparagraph.''. (ii) Prohibition on admission of new resident; audits.--Section 1919(h) of the Social Security Act (42 U.S.C. 1396r(h)) is amended-- (I) in paragraph (1), by striking ``If a State finds, on the basis of a standard'' and inserting ``Subject to paragraph (10), if a State finds, on the basis of a standard''; (II) in paragraph (2)-- (aa) in subparagraph (C), by striking ``If a nursing facility'' and inserting ``Subject to paragraph (10), if a nursing facility''; and (bb) in subparagraph (D), by striking ``In the case of'' and inserting ``Subject to paragraph (10), in the case of''; (III) in paragraph (3)-- (aa) in subparagraph (A), by inserting before the period the following: ``and the remedies described in paragraph (10)(B)''; and (bb) in subparagraph (B), by striking ``With respect to'' and inserting ``Subject to paragraph (10), with respect to''; and (IV) by adding at the end the following new paragraph: ``(10) Special rule with respect to minimum nurse staffing requirements.-- ``(A) In general.--Beginning January 1, 2029, if a State finds, on the basis of a standard, extended, or partial extended survey under subsection (g)(2) or otherwise, that a nursing facility does not meet the minimum staffing requirements of subsection (b)(4)(D) (without regard to whether such facility has in effect a waiver of such requirements under clause (iii) of such subsection), the State shall-- ``(i) deny any further payments under the State plan with respect to all individuals enrolled under such plan who are admitted to the facility after the effective date of the finding; and ``(ii) recommend to the Secretary that the Secretary take such actions as described in subparagraph (B). ``(B) Secretarial authority.--Beginning January 1, 2029, with respect to any nursing facility in a State other than a State nursing facility, if the Secretary finds, or pursuant to a recommendation of the State under subparagraph (A) finds, that a skilled nursing facility does not meet the minimum staffing requirements of subsection (b)(4)(D) (without regard to whether such facility has in effect a waiver of such requirements under clause (iii) of such subsection), the Secretary shall deny any further payments to the State for medical assistance furnished by the facility to any individual admitted to the facility for the period beginning on the effective date of the finding and ending on the later of-- ``(i) the date that is 180 days after such effective date; or ``(ii) the date on which the Secretary determines that the facility has come into compliance with such minimum staffing requirements. ``(C) Relationship to other enforcement mechanisms.--The remedies provided under this paragraph are in addition to those otherwise available under this subsection and shall not be construed as limiting such other remedies.''. (iii) Ineligibility for certain state directed payments.--The Secretary of Health and Human Services shall revise section 438.6(c)(2) of title 42, Code of Federal Regulations (or a successor regulation), such that, beginning January 1, 2029, no State directed payment specified in such section may be made for nursing facility services furnished by a facility that does not meet the minimum staffing requirements of subparagraph (D) of section 1919(b)(4) of the Social Security Act (42 U.S.C. 1396r(b)(4)), as added by subparagraph (A) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subparagraph). (iv) Application to transfer and discharge rights.--Section 1919(c)(2)(A) of the Social Security Act (42 U.S.C. 1396r(c)(2)(A)) is amended by adding at the end of the flush-left text the following new sentence: ``Beginning January 1, 2029, a nursing facility may not transfer or discharge a resident solely for purposes of meeting the minimum staffing requirements under subsection (b)(4)(D).''. (v) Notice of noncompliance to residents and guardians.-- (I) In general.--Section 1919(c) of the Social Security Act (42 U.S.C. 1396r(c)) is amended by adding at the end the following new paragraph: ``(9) Notice in the case of noncompliance with minimum staffing standards.--Beginning January 1, 2029, in the case of a nursing facility that does not meet the minimum staffing requirements of subsection (b)(4)(D) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subsection), such facility shall-- ``(A) prominently display at the entrance to the facility a notice that such facility does not meet such standards (and has in effect such a waiver, if applicable); and ``(B) provide each resident of the facility (or, where appropriate, the guardians or legal representatives of such residents) and members of their immediate families with a written copy of such notice.''. (II) Nursing home compare website.--Section 1919(i)(1)(A)(i) of the Social Security Act (42 U.S.C. 1396r(i)(1)(A)(i)) is amended by inserting ``(and, beginning January 1, 2029, information on whether the facility meets the minimum staffing requirements of subsection (b)(4)(D) (or has in effect a waiver of such requirements under clause (iii) of such subsection)'' after ``staffing turnover and tenure''. (C) Conforming amendments.-- (i) Item (a) of section 1919(f)(2)(B)(iii)(I) of the Social Security Act (42 U.S.C. 1396r(f)(2)(B)(iii)(I)) is amended by inserting ``or subsection (b)(4)(D)(iii)'' after ``subsection (b)(4)(C)(ii)''. (ii) Paragraph (9) of section 1919(f) of the Social Security Act (42 U.S.C. 1396r(f)) is amended by inserting ``or subsection (b)(4)(D)(iii)'' after ``subsection (b)(4)(C)(ii)''. (b) Inclusion of Timestamp on Facility Staffing Data.--Section 1128I(g) of the Social Security Act (42 U.S.C. 1320a-7j(g)) is amended-- (1) in paragraph (3), by striking ``and'' at the end; (2) in paragraph (4), by striking the period at the end and inserting ``; and''; and (3) by inserting after paragraph (4) the following new paragraph: ``(5) beginning January 1, 2027, include time-stamped information on the hours worked per day by each certified employee in each category of certified employees referenced in paragraph (1).''. (c) Reports.--Section 1128I of the Social Security Act (42 U.S.C. 1320a-7j) is amended by adding at the end the following new subsection: ``(i) Reports on Facility Staffing Levels.--Not later than January 1, 2034, and every 5 years thereafter, the Secretary of Health and Human Services shall submit to Congress a report on the minimum nurse staffing levels required under sections 1819(b)(4)(D) and 1919(b)(4)(D). Each such report shall include-- ``(1) an analysis of the impact of such minimum nurse staffing levels on-- ``(A) resident safety; ``(B) quality of care; ``(C) the rate of deficiency citations received by facilities; and ``(D) wages, benefits, and employment retention of nurse staff; and ``(2) recommendations as to whether such minimum nurse staffing levels should be adjusted.''. <all>\n\nSUMMARY TO EVALUATE:\nTitle: Safe Staffing Saves Lives Act: New Nursing Home Standards\nSummary: This act sets mandatory minimum staffing levels for nursing homes to ensure residents receive adequate care and attention. It requires facilities to have enough nurses and aides available 24/7 to improve safety and health outcomes for seniors.\nKey Points: Requires a minimum of 4.1 hours of nursing care per resident per day., Mandates a registered nurse to be onsite and available 24 hours a day, 7 days a week., Facilities must publicly post notices if they fail to meet the required staffing levels., Prohibits transferring or discharging residents solely to meet staffing ratio requirements., Implements financial penalties and increased inspections for non-compliant facilities.\n\nZASADY OCENY:\n1. Sprawdź wszystkie LICZBY, DATY i KWOTY w SUMMARY. Jeśli którejś brakuje w SOURCE -> is_valid: false.\n2. Sprawdź wszystkie NAZWISKA, ORGANIZACJE i MIEJSCA w SUMMARY. Jeśli którejś brakuje w SOURCE -> is_valid: false.\n3. Sprawdź wszystkie konkretne DZIAŁANIA PRAWNE . Jeśli tego mechanizmu nie ma w SOURCE -> is_valid: false.\n\nWAŻNE: Abstrakcyjne pojęcia (np. \"transparentność\", \"zaufanie\") są dozwolone jako wnioski.\n\nOUTPUT (JSON):\n{\n  \"is_valid\": true/false,\n  \"issue\": \"fabricated_entity\" / \"contradiction\" / \"none\"\n}\n\nWYMAGANIA FORMATOWANIA:\n1. Odpowiedz WYŁĄCZNIE surowym obiektem JSON.\n2. NIE używaj bloków kodu Markdown.\n3. NIE dodawaj żadnych wstępów ani wyjaśnień przed ani po JSONie.\n4. JSON musi być poprawny i gotowy do parsowania.\n\n",
      "ai_response_raw": "{\n  \"is_valid\": true,\n  \"issue\": \"none\"\n}"
    },
    {
      "timestamp": "2026-04-01T11:15:10.000Z",
      "source_url": "https://www.congress.gov/119/bills/hr8100/BILLS-119hr8100ih.htm",
      "model": "gemini-flash-latest",
      "prompt_sent": "\nJesteś ekspertem od prawa Stanów Zjednoczonych, który ma za zadanie analizować dokumenty ustaw, uchwał oraz innych dokumentów legislacyjnych, a następnie przygotowywać z nich informacje w przystępny sposób dla obywateli. Twoim celem jest przedstawienie informacji tak, aby obywatele mogli sami ocenić wpływ legislacji na ich życie, nawet bez posiadania specjalistycznej wiedzy legislacyjnej. Skup się na faktach i obiektywnych skutkach wprowadzanych zmian, unikając wartościowania i osobistych opinii. Wszelki żargon prawny jest zabroniony. Prezentuj informacje w jasny, zwięzły i angażujący sposób, tak aby były zrozumiałe dla osoby bez wykształcenia prawniczego. Unikaj długich, złożonych zdań. Zamiast pisać \"projekt ma na celu nowelizację kodeksu podatkowego...\", napisz \"Zmiany w podatkach: nowe ulgi i obowiązki dla...\". Kontynuuj swoją pracę, dopóki nie rozwiążesz swojego zadania. Jeśli nie masz pewności co do generowanej treści, przeanalizuj dokument ponownie – nie zgaduj. Rozplanuj dobrze swoje zadanie przed przystąpieniem do niego. W podsumowaniu i kluczowych punktach, jeśli to możliwe i uzasadnione, podkreśl, jakie konkretne korzyści lub skutki (pozytywne lub negatywne) wprowadza ustawa dla życia codziennego obywateli, ich praw i obowiązków, finansów osobistych, bezpieczeństwa i innych ważnych kwestii (np. kategorycznych zakazów i nakazów czy najważniejszych konkretnych alokacji finansowych i terytorialnych).\n\nTwoja odpowiedź MUSI być w formacie JSON - i zawierać następujące klucze.\nZanim zwrócisz odpowiedź, dokładnie zweryfikuj, czy cała struktura JSON jest w 100% poprawna, włącznie ze wszystkimi przecinkami, nawiasami klamrowymi, kwadratowymi oraz cudzysłowami. Błędny JSON jest nieakceptowalny i uniemożliwi przetworzenie Twojej pracy.\n\nPrzeanalizuj dokładnie poniższy tekst dokumentu prawnego. To jest treść, na podstawie której masz wygenerować podsumowanie i kluczowe punkty:\n--- POCZĄTEK DOKUMENTU ---\n[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 8100 Introduced in House (IH)] <DOC> 119th CONGRESS 2d Session H. R. 8100 To amend titles XI, XVIII, and XIX of the Social Security Act with respect to minimum staffing levels in skilled nursing facilities and nursing facilities under the Medicare and Medicaid programs. _______________________________________________________________________ IN THE HOUSE OF REPRESENTATIVES March 26, 2026 Mr. Doggett (for himself and Ms. Schakowsky) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned _______________________________________________________________________ A BILL To amend titles XI, XVIII, and XIX of the Social Security Act with respect to minimum staffing levels in skilled nursing facilities and nursing facilities under the Medicare and Medicaid programs. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Safe Staffing Saves Lives Act''. SEC. 2. MINIMUM STAFFING LEVELS IN NURSING FACILITIES AND SKILLED NURSING FACILITIES. (a) Establishing Minimum Staffing Levels for Registered Nurses in Nursing Facilities and Skilled Nursing Facilities.-- (1) Medicare.-- (A) In general.--Section 1819(b)(4) of the Social Security Act (42 U.S.C. 1395i-3(b)(4)) is amended-- (i) in subparagraph (C)-- (I) in the subparagraph heading, by inserting ``before 2029'' after ``Required nursing care''; and (II) in clause (i), by striking ``Except as provided in clause (ii)'' and inserting ``With respect to skilled nursing facility services furnished before January 1, 2029, except as provided in clause (ii)''; and (ii) by adding at the end the following new subparagraph: ``(D) Required nursing care beginning in 2029.-- ``(i) In general.--Subject to clause (iii), beginning January 1, 2029, a skilled nursing facility-- ``(I) must provide 24-hour licensed nursing services which are sufficient to meet the nursing needs of its residents; ``(II) must provide for minimum nurse staffing levels with respect to each day; ``(III) must ensure that, in carrying out subclauses (I) and (II), a total minimum of 4.1 hours of nursing care is provided per resident per day, with-- ``(aa) 1.3 hours of care of such total minimum consisting of licensed nursing services, with 0.75 hours of such care provided by a registered professional nurse and 0.55 hours of such care provided by a licensed practical nurse; and ``(bb) 2.8 hours of care of such total minimum provided by a nurse aide (as defined in paragraph (5)(F)); and ``(IV) must ensure that a registered professional nurse is onsite and available to furnish licensed nursing services 24 hours a day, 7 days a week. ``(ii) Secretarial authority to establish higher minimum nurse staffing levels.--The Secretary may establish and require skilled nursing facilities to provide for minimum nurse staffing levels that are higher than the levels required under this subparagraph. ``(iii) Waiver.-- ``(I) In general.--Subject to the succeeding provisions of this clause, the Secretary may waive the requirements under clause (i) (and such additional requirements as may be established under clause (ii)) with respect to a skilled nursing facility for a period of not more than 180 days if-- ``(aa) the facility demonstrates to the satisfaction of the Secretary that the facility cannot reasonably comply with such requirements; ``(bb) the facility provides to the Secretary such information as the Secretary determines necessary to support a determination under item (aa), which shall include information with respect to-- ``(AA) workforce and wage data for the area in which the facility is located; ``(BB) additional employee benefits offered by the facility; ``(CC) the annual rate of turnover with respect to nursing staff at the facility, disaggregated by category of staff; and ``(DD) the facility's demonstrated commitment to hiring nursing staff; and ``(cc) the Secretary provides notice of the waiver to the State long-term care ombudsman (established under section 307(a)(12) of the Older Americans Act of 1965) and the protection and advocacy system in the State for the mentally ill and the mentally retarded. ``(II) Ineligibility.--The Secretary may not grant a waiver under this clause to a skilled nursing facility that-- ``(aa) has been identified under the special focus facility program under subsection (f)(8) as having substantially failed to meet an applicable requirement of this Act; or ``(bb) during the 1-year period preceding a request for such a waiver, was found to have deficiencies that-- ``(AA) resulted in harm to a resident; or ``(BB) immediately jeopardized the health or safety of its residents. ``(III) Limitations.--A skilled nursing facility may not receive more than 2 consecutive waivers under this clause. ``(iv) Rule of construction regarding state authority to establish higher minimum nurse staffing levels.--Nothing in this subparagraph may be construed as preventing a State from establishing or requiring skilled nursing facilities in the State to provide for minimum nurse staffing levels that are higher than the levels required under this subparagraph.''. (B) Enforcement.-- (i) Increased survey frequency.--Section 1819(g)(2)(A)(iii) of the Social Security Act (42 U.S.C. 1395i-3(g)(2)(A)(iii)) is amended-- (I) in subclause (I), by striking ``Each'' and inserting ``Subject to subclause (III), each''; and (II) by adding at the end the following new subclause: ``(III) Staffing level surveys.-- Beginning January 1, 2029, in the case of a skilled nursing facility that is found not to meet the minimum staffing requirements of subsection (b)(4)(D) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subsection), such facility shall be subject to a standard survey not later than 3 months after the date of the previous standard survey conducted under this subparagraph.''. (ii) Prohibition on admission of new residents; audits.--Section 1819(h) of the Social Security Act (42 U.S.C. 1395i-3(h)) is amended-- (I) in paragraph (1), by striking ``If a State finds, on the basis of a standard'' and inserting ``Subject to paragraph (7), if a State finds, on the basis of a standard''; (II) in paragraph (2), by striking ``With respect to'' and inserting ``Subject to paragraph (7), with respect to''; and (III) by adding at the end the following new paragraph: ``(7) Special rule with respect to minimum nurse staffing requirements.-- ``(A) In general.--Beginning January 1, 2029, if a State finds, on the basis of a standard, extended, or partial extended survey under subsection (g)(2) or otherwise, that a skilled nursing facility does not meet the minimum staffing requirements of subsection (b)(4)(D) (without regard to whether such facility has in effect a waiver of such requirements under clause (iii) of such subsection), the State shall recommend to the Secretary that the Secretary take such actions as described in subparagraph (B). ``(B) Secretarial authority.--Beginning January 1, 2029, with respect to any skilled nursing facility in a State, if the Secretary finds, or pursuant to a recommendation of the State under subparagraph (A) finds, that a skilled nursing facility does not meet the minimum staffing requirements of subsection (b)(4)(D) (without regard to whether such facility has in effect a waiver of such requirements under clause (iii) of such subsection), the Secretary shall deny any further payments under this title with respect to any individuals entitled to benefits under this title admitted to the facility for the period beginning on the effective date of the finding and ending on the later of-- ``(i) the date that is 180 days after such effective date; or ``(ii) the date on which the Secretary determines that the facility has come into compliance with such minimum staffing requirements. ``(C) Relationship to other enforcement mechanisms.--The remedies provided under this paragraph are in addition to those otherwise available under this subsection and shall not be construed as limiting such other remedies.''. (iii) Ineligibility for snf vbp program.-- Section 1888(h)(1)(C) of the Social Security Act (42 U.S.C. 1395yy(h)(1)(C)) is amended-- (I) by redesignating clauses (i) and (ii) as subclauses (I) and (II), respectively, and adjusting the margins accordingly; (II) by striking ``With respect'' and inserting the following: ``(i) In general.--With respect''; and (III) by adding at the end the following new clause: ``(ii) Exclusion of facilities out of compliance with minimum staffing standards.-- With respect to payments for services furnished on or after January 1, 2029, this subsection shall not apply to a facility that does not meet the minimum staffing requirements of subsection (b)(4)(D) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subsection).''. (C) Application to transfer and discharge rights.-- Section 1819(c)(2)(A) of the Social Security Act (42 U.S.C. 1395i-3(c)(2)(A)) is amended by adding at the end of the flush-left text the following new sentence: ``Beginning January 1, 2029, a skilled nursing facility may not transfer or discharge a resident solely for purposes of meeting the minimum staffing requirements under subsection (b)(4)(D).''. (D) Notice of noncompliance to residents and guardians.-- (i) In general.--Section 1819(c) of the Social Security Act (42 U.S.C. 1395i-3(c)) is amended by adding at the end the following new paragraph: ``(7) Notice in the case of noncompliance with minimum staffing standards.--Beginning January 1, 2029, in the case of a skilled nursing facility that does not meet the minimum staffing requirements of subsection (b)(4)(D) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subsection), such facility shall-- ``(A) prominently display at the entrance to the facility a notice that such facility does not meet such standards (and has in effect such a waiver, if applicable); and ``(B) provide each resident of the facility (or, where appropriate, the guardians or legal representatives of such residents) and members of their immediate families with a written copy of such notice.''. (ii) Nursing home compare website.--Section 1819(i)(1)(A)(i) of the Social Security Act (42 U.S.C. 1395i-3(i)(1)(A)(i)) is amended by inserting ``(and, beginning January 1, 2029, information on whether the facility meets the minimum staffing requirements of subsection (b)(4)(D) (or has in effect a waiver of such requirements under clause (iii) of such subsection)'' after ``staffing turnover and tenure''. (E) Conforming amendment.--Section 1819(f)(2)(B)(iii)(I)(a) of the Social Security Act (42 U.S.C. 1395i-3(f)(2)(B)(iii)(I)(a)) is amended by inserting ``or subsection (b)(4)(D)(iii)'' after ``subsection (b)(4)(C)(ii)(II)''. (2) Medicaid.-- (A) In general.--Section 1919(b)(4) of the Social Security Act (42 U.S.C. 1396r(b)(4)) is amended-- (i) in subparagraph (C)(i)-- (I) in the clause heading, by inserting ``before 2029'' after ``General requirements''; and (II) in the matter preceding subclause (I), by inserting ``and before January 1, 2029,'' after ``With respect to nursing facility services provided on or after October 1, 1990,''; and (ii) by adding at the end the following new subparagraph: ``(D) General requirements beginning in 2029.-- ``(i) In general.--Subject to clause (iii), beginning January 1, 2029, a nursing facility-- ``(I) must provide 24-hour licensed nursing services which are sufficient to meet the nursing needs of its residents; ``(II) must provide for minimum nurse staffing levels with respect to each day; ``(III) must ensure that, in carrying out subclauses (I) and (II), a total minimum of 4.1 hours of nursing care is provided per resident per day, with-- ``(aa) 1.3 hours of care of such total minimum consisting of licensed nursing services, with 0.75 hours of such care provided by a registered professional nurse and 0.55 hours of such care provided by a licensed practical nurse; and ``(bb) 2.8 hours of care of such total minimum provided by a nurse aide (as defined in paragraph (5)(F)); and ``(IV) must ensure that a registered professional nurse is onsite and available to furnish licensed nursing services 24 hours a day, 7 days a week. ``(ii) Secretarial authority to establish higher minimum nurse staffing levels.--The Secretary may establish and require nursing facilities to provide for minimum nurse staffing levels that are higher than the levels required under this subparagraph. ``(iii) Waiver.-- ``(I) In general.--Subject to the succeeding provisions of this clause, a State may waive the requirements under clause (i) (and such additional requirements as may be established under clause (ii)) with respect to a nursing facility for a period of not more than 180 days if-- ``(aa) the facility demonstrates to the satisfaction of the State that the facility cannot reasonably comply with such requirements; ``(bb) the facility provides to the State such information as the State determines necessary to support a determination under item (aa), which shall include information with respect to-- ``(AA) workforce and wage data for the area in which the facility is located; ``(BB) additional employee benefits offered by the facility; ``(CC) the annual rate of turnover with respect to nursing staff at the facility, disaggregated by category of staff; and ``(DD) the facility's demonstrated commitment to hiring nursing staff; and ``(cc) the State agency granting a waiver of such requirements provides notice of the waiver to the State long- term care ombudsman (established under section 307(a)(12) of the Older Americans Act of 1965) and the protection and advocacy system in the State for the mentally ill and the mentally retarded. A waiver under this clause shall be subject to the review of the Secretary and subject to clause (iv) shall be accepted by the Secretary for purposes of this title to the same extent as is the State's certification of the facility. In granting or renewing a waiver, a State may require the facility to use other qualified, licensed personnel. ``(II) Ineligibility.--The State may not grant a waiver under this clause to a skilled nursing facility that-- ``(aa) has been identified under the special focus facility program under subsection (f)(10) as having substantially failed to meet applicable requirements of this Act; or ``(bb) during the 1-year period preceding a request for such a waiver, was found to have deficiencies that-- ``(AA) resulted in harm to a resident; or ``(BB) immediately jeopardized the health or safety of its residents. ``(III) Limitations.--A nursing facility may not receive more than 2 consecutive waivers under this clause. ``(iv) Assumption of waiver authority by secretary.--If the Secretary determines that a State has shown a clear pattern and practice of allowing waivers in the absence of diligent efforts by facilities to meet the staffing requirements, the Secretary shall assume and exercise the authority of the State to grant waivers. ``(v) Rule of construction regarding state authority to establish higher minimum nurse staffing levels.--Nothing in this subparagraph may be construed as preventing a State from establishing or requiring skilled nursing facilities in the State to provide for minimum nurse staffing levels that are higher than the levels required under this subparagraph.''. (B) Enforcement.-- (i) Increased survey frequency.--Section 1919(g)(2)(A)(iii) of the Social Security Act (42 U.S.C. 1396r(g)(2)(A)(iii)) is amended-- (I) in subclause (I), by striking ``Each'' and inserting ``Subject to subclause (III), each''; and (II) by adding at the end the following new subclause: ``(III) Staffing level surveys.-- Beginning January 1, 2029, in the case of a nursing facility that is found not to meet the minimum staffing requirements of subsection (b)(4)(D) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subsection), such facility shall be subject to a standard survey not later than 3 months after the date of the previous standard survey conducted under this subparagraph.''. (ii) Prohibition on admission of new resident; audits.--Section 1919(h) of the Social Security Act (42 U.S.C. 1396r(h)) is amended-- (I) in paragraph (1), by striking ``If a State finds, on the basis of a standard'' and inserting ``Subject to paragraph (10), if a State finds, on the basis of a standard''; (II) in paragraph (2)-- (aa) in subparagraph (C), by striking ``If a nursing facility'' and inserting ``Subject to paragraph (10), if a nursing facility''; and (bb) in subparagraph (D), by striking ``In the case of'' and inserting ``Subject to paragraph (10), in the case of''; (III) in paragraph (3)-- (aa) in subparagraph (A), by inserting before the period the following: ``and the remedies described in paragraph (10)(B)''; and (bb) in subparagraph (B), by striking ``With respect to'' and inserting ``Subject to paragraph (10), with respect to''; and (IV) by adding at the end the following new paragraph: ``(10) Special rule with respect to minimum nurse staffing requirements.-- ``(A) In general.--Beginning January 1, 2029, if a State finds, on the basis of a standard, extended, or partial extended survey under subsection (g)(2) or otherwise, that a nursing facility does not meet the minimum staffing requirements of subsection (b)(4)(D) (without regard to whether such facility has in effect a waiver of such requirements under clause (iii) of such subsection), the State shall-- ``(i) deny any further payments under the State plan with respect to all individuals enrolled under such plan who are admitted to the facility after the effective date of the finding; and ``(ii) recommend to the Secretary that the Secretary take such actions as described in subparagraph (B). ``(B) Secretarial authority.--Beginning January 1, 2029, with respect to any nursing facility in a State other than a State nursing facility, if the Secretary finds, or pursuant to a recommendation of the State under subparagraph (A) finds, that a skilled nursing facility does not meet the minimum staffing requirements of subsection (b)(4)(D) (without regard to whether such facility has in effect a waiver of such requirements under clause (iii) of such subsection), the Secretary shall deny any further payments to the State for medical assistance furnished by the facility to any individual admitted to the facility for the period beginning on the effective date of the finding and ending on the later of-- ``(i) the date that is 180 days after such effective date; or ``(ii) the date on which the Secretary determines that the facility has come into compliance with such minimum staffing requirements. ``(C) Relationship to other enforcement mechanisms.--The remedies provided under this paragraph are in addition to those otherwise available under this subsection and shall not be construed as limiting such other remedies.''. (iii) Ineligibility for certain state directed payments.--The Secretary of Health and Human Services shall revise section 438.6(c)(2) of title 42, Code of Federal Regulations (or a successor regulation), such that, beginning January 1, 2029, no State directed payment specified in such section may be made for nursing facility services furnished by a facility that does not meet the minimum staffing requirements of subparagraph (D) of section 1919(b)(4) of the Social Security Act (42 U.S.C. 1396r(b)(4)), as added by subparagraph (A) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subparagraph). (iv) Application to transfer and discharge rights.--Section 1919(c)(2)(A) of the Social Security Act (42 U.S.C. 1396r(c)(2)(A)) is amended by adding at the end of the flush-left text the following new sentence: ``Beginning January 1, 2029, a nursing facility may not transfer or discharge a resident solely for purposes of meeting the minimum staffing requirements under subsection (b)(4)(D).''. (v) Notice of noncompliance to residents and guardians.-- (I) In general.--Section 1919(c) of the Social Security Act (42 U.S.C. 1396r(c)) is amended by adding at the end the following new paragraph: ``(9) Notice in the case of noncompliance with minimum staffing standards.--Beginning January 1, 2029, in the case of a nursing facility that does not meet the minimum staffing requirements of subsection (b)(4)(D) (including such a facility that has in effect a waiver of such requirements under clause (iii) of such subsection), such facility shall-- ``(A) prominently display at the entrance to the facility a notice that such facility does not meet such standards (and has in effect such a waiver, if applicable); and ``(B) provide each resident of the facility (or, where appropriate, the guardians or legal representatives of such residents) and members of their immediate families with a written copy of such notice.''. (II) Nursing home compare website.--Section 1919(i)(1)(A)(i) of the Social Security Act (42 U.S.C. 1396r(i)(1)(A)(i)) is amended by inserting ``(and, beginning January 1, 2029, information on whether the facility meets the minimum staffing requirements of subsection (b)(4)(D) (or has in effect a waiver of such requirements under clause (iii) of such subsection)'' after ``staffing turnover and tenure''. (C) Conforming amendments.-- (i) Item (a) of section 1919(f)(2)(B)(iii)(I) of the Social Security Act (42 U.S.C. 1396r(f)(2)(B)(iii)(I)) is amended by inserting ``or subsection (b)(4)(D)(iii)'' after ``subsection (b)(4)(C)(ii)''. (ii) Paragraph (9) of section 1919(f) of the Social Security Act (42 U.S.C. 1396r(f)) is amended by inserting ``or subsection (b)(4)(D)(iii)'' after ``subsection (b)(4)(C)(ii)''. (b) Inclusion of Timestamp on Facility Staffing Data.--Section 1128I(g) of the Social Security Act (42 U.S.C. 1320a-7j(g)) is amended-- (1) in paragraph (3), by striking ``and'' at the end; (2) in paragraph (4), by striking the period at the end and inserting ``; and''; and (3) by inserting after paragraph (4) the following new paragraph: ``(5) beginning January 1, 2027, include time-stamped information on the hours worked per day by each certified employee in each category of certified employees referenced in paragraph (1).''. (c) Reports.--Section 1128I of the Social Security Act (42 U.S.C. 1320a-7j) is amended by adding at the end the following new subsection: ``(i) Reports on Facility Staffing Levels.--Not later than January 1, 2034, and every 5 years thereafter, the Secretary of Health and Human Services shall submit to Congress a report on the minimum nurse staffing levels required under sections 1819(b)(4)(D) and 1919(b)(4)(D). Each such report shall include-- ``(1) an analysis of the impact of such minimum nurse staffing levels on-- ``(A) resident safety; ``(B) quality of care; ``(C) the rate of deficiency citations received by facilities; and ``(D) wages, benefits, and employment retention of nurse staff; and ``(2) recommendations as to whether such minimum nurse staffing levels should be adjusted.''. <all>\n--- KONIEC DOKUMENTU ---\n\nPAMIĘTAJ: Twoja odpowiedź MUSI być wyłącznie poprawnym obiektem JSON. Nie dodawaj żadnych dodatkowych znaków, komentarzy ani tekstu przed znacznikiem '{' ani po znaczniku '}'. Cała odpowiedź musi być parsowalna jako JSON.\nNa podstawie POWYŻSZEGO dokumentu, wypełnij poniższą strukturę JSON:\nOto struktura JSON, której oczekuję (wypełnij ją treścią):\n{\n  \"pl_ai_title\": \"Nowy, krótki tytuł dla aktu prawnego po polsku, oddający sedno wprowadzanych zmian (np. maksymalnie 10-12 słów).\",\n  \"pl_summary\": \"2-3 zdania zwięzłego podsumowania treści aktu prawnego po polsku, napisane z perspektywy wpływu na życie codzienne obywateli.\",\n  \"pl_key_points\": [\n    \"Pierwszy krótki punkt po polsku dotyczący najważniejszych wprowadzanych rozwiązań lub zmian.\",\n    \"Drugi krótki punkt po polsku...\"\n  ],\n  \"eng_ai_title\": \"A new, short title for the legal act in English, capturing the essence of the changes (e.g., max 10-12 words).\",\n  \"eng_summary\": \"2-3 sentences summarizing the legal act in English, from the perspective of its impact on citizens' daily lives.\",\n  \"eng_key_points\": [\n    \"First short bullet point in English regarding the most important solutions or changes being introduced.\",\n    \"Second short bullet point in English...\"\n  ],\n  \"de_ai_title\": \"Ein neuer, kurzer Titel für das Rechtsdokument auf Deutsch, der den Kern der Änderungen erfasst (z.B. max. 10-12 Wörter).\",\n  \"de_summary\": \"2-3 Sätze Zusammenfassung des Rechtsdokuments auf Deutsch, aus der Perspektive seiner Auswirkungen auf das tägliche Leben der Bürger.\",\n  \"de_key_points\": [\n    \"Erster kurzer Stichpunkt auf Deutsch zu den wichtigsten eingeführten Lösungen oder Änderungen.\",\n    \"Zweiter kurzer Stichpunkt auf Deutsch...\"\n  ],\n  \"fr_ai_title\": \"Un nouveau titre court pour l'acte juridique en français, saisissant l'essence des changements (par exemple, 10-12 mots maximum).\",\n  \"fr_summary\": \"Résumé de 2-3 phrases de l'acte juridique en français, du point de vue de son impact sur la vie quotidienne des citoyens.\",\n  \"fr_key_points\": [\n    \"Premier court point en français concernant les solutions ou changements les plus importants introduits.\",\n    \"Deuxième court point en français...\"\n  ],\n  \"es_ai_title\": \"Un nuevo título breve para el acto jurídico en español, que recoja la esencia de los cambios (por ejemplo, máximo 10-12 palabras).\",\n  \"es_summary\": \"Resumen de 2-3 frases del acto jurídico en español, desde la perspectiva de su impacto en la vida cotidiana de los ciudadanos.\",\n  \"es_key_points\": [\n    \"Primer punto breve en español sobre las soluciones o cambios más importantes que se introducen.\",\n    \"Segundo punto breve en español...\"\n  ],\n  \"it_ai_title\": \"Un nuovo titolo breve per l'atto giuridico in italiano, che colga l'essenza delle modifiche (ad es. massimo 10-12 parole).\",\n  \"it_summary\": \"Riepilogo di 2-3 frasi dell'atto giuridico in italiano, dal punto di vista del suo impatto sulla vita quotidiana dei cittadini.\",\n  \"it_key_points\": [\n    \"Primo breve punto in italiano riguardante le soluzioni o le modifiche più importanti introdotte.\",\n    \"Secondo breve punto in italiano...\"\n  ],\n  \"nl_ai_title\": \"Een nieuwe, korte titel voor de rechtshandeling in het Nederlands, die de essentie van de wijzigingen weergeeft (bijv. max. 10-12 woorden).\",\n  \"nl_summary\": \"Samenvatting van 2-3 zinnen van de rechtshandeling in het Nederlands, vanuit het perspectief van de impact op het dagelijks leven van burgers.\",\n  \"nl_key_points\": [\n    \"Eerste korte punt in het Nederlands betreffende de belangrijkste geïntroduceerde oplossingen of wijzigingen.\",\n    \"Tweede korte punt in het Nederlands...\"\n  ],\n  \"pt_ai_title\": \"Um novo título curto para o ato jurídico em português, capturando a essência das mudanças (por exemplo, máx. 10-12 palavras).\",\n  \"pt_summary\": \"Resumo de 2-3 frases do ato jurídico em português, na perspetiva do seu impacto na vida quotidiana dos cidadãos.\",\n  \"pt_key_points\": [\n    \"Primeiro ponto curto em português sobre as soluções ou alterações mais importantes introduzidas.\",\n    \"Segundo ponto curto em português...\"\n  ],\n  \"category\": [\"Categorize the document into one category by default, based on the field it primarily concerns. Choose up to 3 if the document also touches upon SIGNIFICANT issues from other categories. You MUST select categories ONLY from the following list: Health, Education, Family, Taxes, Labor, Security, Environment, Courts and Law, Transport, Benefits, Real Estate, Media and Culture, Local Government, Migration, Agriculture, Public Investments, Informatization, Economy. If the document does not definitively fit any of these, you MUST use \"Other\". If you use \"Other\", it should be the ONLY category selected. Do NOT invent new categories. The response must be an array of strings, e.g., [\"Taxes\", \"Family\"].\"]\n}\n\n",
      "ai_response_raw": "{\n  \"pl_ai_title\": \"Ustawa o bezpiecznej liczbie personelu w domach opieki\",\n  \"pl_summary\": \"Ustawa wprowadza obowiązkowe minimalne normy zatrudnienia pielęgniarek i opiekunów w domach opieki finansowanych z programów Medicare i Medicaid. Zmiany mają na celu poprawę bezpieczeństwa i jakości opieki nad seniorami poprzez zapewnienie stałej obecności wykwalifikowanego personelu.\",\n  \"pl_key_points\": [\n    \"Zapewnienie minimum 4,1 godziny opieki pielęgniarskiej na każdego mieszkańca dziennie.\",\n    \"Obowiązkowa obecność pielęgniarki dyplomowanej w placówce przez 24 godziny na dobę, 7 dni w tygodniu.\",\n    \"Obowiązek informowania mieszkańców i ich rodzin o niespełnianiu norm kadrowych poprzez specjalne ogłoszenia.\",\n    \"Zakaz przenoszenia lub wypisywania pacjentów wyłącznie w celu sztucznego poprawienia statystyk zatrudnienia.\",\n    \"Wprowadzenie kar finansowych i częstszych kontroli dla placówek, które nie przestrzegają nowych standardów.\"\n  ],\n  \"eng_ai_title\": \"Safe Staffing Saves Lives Act: New Nursing Home Standards\",\n  \"eng_summary\": \"This act sets mandatory minimum staffing levels for nursing homes to ensure residents receive adequate care and attention. It requires facilities to have enough nurses and aides available 24/7 to improve safety and health outcomes for seniors.\",\n  \"eng_key_points\": [\n    \"Requires a minimum of 4.1 hours of nursing care per resident per day.\",\n    \"Mandates a registered nurse to be onsite and available 24 hours a day, 7 days a week.\",\n    \"Facilities must publicly post notices if they fail to meet the required staffing levels.\",\n    \"Prohibits transferring or discharging residents solely to meet staffing ratio requirements.\",\n    \"Implements financial penalties and increased inspections for non-compliant facilities.\"\n  ],\n  \"de_ai_title\": \"Gesetz für sichereres Personal in Pflegeheimen\",\n  \"de_summary\": \"Dieses Gesetz führt verbindliche Mindestbesetzungsstärken für Pflegepersonal in Heimen ein, die über Medicare und Medicaid finanziert werden. Ziel ist es, die Versorgungsqualität und Sicherheit der Bewohner durch mehr Personal zu erhöhen.\",\n  \"de_key_points\": [\n    \"Mindestens 4,1 Pflegestunden pro Bewohner und Tag sind gesetzlich vorgeschrieben.\",\n    \"Eine examinierte Pflegekraft muss rund um die Uhr (24/7) vor Ort im Heim anwesend sein.\",\n    \"Pflegeheime müssen Bewohner und Angehörige schriftlich informieren, wenn Personalvorgaben nicht erfüllt werden.\",\n    \"Verbot der Verlegung von Bewohnern nur um die vorgeschriebenen Personalquoten einzuhalten.\",\n    \"Sanktionen wie Zahlungsstopps für neue Aufnahmen bei Verstößen gegen die Personalregeln.\"\n  ],\n  \"fr_ai_title\": \"Loi sur les effectifs de sécurité dans les maisons de retraite\",\n  \"fr_summary\": \"Cette loi impose des niveaux minimaux de personnel infirmier dans les établissements de soins financés par Medicare et Medicaid. Elle vise à garantir que chaque résident reçoive une attention suffisante pour sa sécurité et son bien-être.\",\n  \"fr_key_points\": [\n    \"Garantie d'un minimum de 4,1 heures de soins infirmiers par résident et par jour.\",\n    \"Présence obligatoire d'un infirmier autorisé sur place 24 heures sur 24 et 7 jours sur 7.\",\n    \"Obligation d'afficher visiblement à l'entrée si l'établissement ne respecte pas les normes d'effectifs.\",\n    \"Interdiction de transférer des résidents dans le seul but d'ajuster artificiellement les ratios de personnel.\",\n    \"Renforcement des inspections et suspension des paiements pour les établissements non conformes.\"\n  ],\n  \"es_ai_title\": \"Ley de Dotación Segura de Personal en Residencias de Ancianos\",\n  \"es_summary\": \"Esta ley establece niveles mínimos obligatorios de personal de enfermería en residencias financiadas por Medicare y Medicaid. El objetivo es mejorar la calidad de vida y la seguridad de los residentes mediante una atención constante y profesional.\",\n  \"es_key_points\": [\n    \"Se exige un mínimo de 4,1 horas de atención de enfermería por residente al día.\",\n    \"Un enfermero registrado debe estar presente en el centro las 24 horas del día, los 7 días de la semana.\",\n    \"Los centros deben notificar por escrito a las familias si no cumplen con los niveles mínimos de personal.\",\n    \"Se prohíbe el traslado de residentes con el único fin de cumplir con los requisitos de personal.\",\n    \"Sanciones financieras y auditorías más frecuentes para los centros que incumplan la normativa.\"\n  ],\n  \"it_ai_title\": \"Legge sul personale sicuro nelle case di cura\",\n  \"it_summary\": \"La legge introduce standard minimi obbligatori per il personale infermieristico nelle strutture di assistenza finanziate da Medicare e Medicaid. Le modifiche mirano a garantire una maggiore sicurezza e una migliore assistenza quotidiana per gli anziani.\",\n  \"it_key_points\": [\n    \"Almeno 4,1 ore di assistenza infermieristica garantite per ogni residente al giorno.\",\n    \"Presenza obbligatoria di un infermiere professionale in sede 24 ore su 24.\",\n    \"Obbligo di esporre avvisi pubblici e informare le famiglie in caso di carenza di personale.\",\n    \"Divieto di trasferire o dimettere pazienti al solo scopo di rispettare i parametri numerici del personale.\",\n    \"Blocco dei pagamenti governativi per le nuove ammissioni in caso di violazione delle norme.\"\n  ],\n  \"nl_ai_title\": \"Wet op Veilige Personeelsbezetting in Verpleeghuizen\",\n  \"nl_summary\": \"Deze wet stelt verplichte minimale personeelsnormen vast voor verpleeghuizen die Medicare- en Medicaid-financiering ontvangen. Het doel is de veiligheid en zorgkwaliteit voor bewoners te verbeteren door voldoende personeel te garanderen.\",\n  \"nl_key_points\": [\n    \"Minimaal 4,1 uur verpleegkundige zorg per bewoner per dag is vereist.\",\n    \"Er moet 24 uur per dag, 7 dagen per week een gediplomeerd verpleegkundige op locatie aanwezig zijn.\",\n    \"Verplichte schriftelijke melding aan bewoners en familie als de personeelsnormen niet worden gehaald.\",\n    \"Het is verboden bewoners over te plaatsen enkel om aan de personeelsratio's te voldoen.\",\n    \"Instellingen die niet voldoen, krijgen vaker inspecties en riskeren stopzetting van vergoedingen.\"\n  ],\n  \"pt_ai_title\": \"Lei de Pessoal Seguro em Lares de Idosos\",\n  \"pt_summary\": \"Esta lei estabelece níveis mínimos obrigatórios de pessoal de enfermagem em lares financiados pelo Medicare e Medicaid. O objetivo é assegurar que os residentes recebam cuidados adequados e contínuos para sua segurança e saúde.\",\n  \"pt_key_points\": [\n    \"Exigência de um mínimo de 4,1 horas de cuidados de enfermagem por residente todos os dias.\",\n    \"Presença obrigatória de um enfermeiro registado no local 24 horas por dia, 7 dias por semana.\",\n    \"Dever de exibir avisos na entrada e informar as famílias caso os níveis de pessoal sejam insuficientes.\",\n    \"Proibição de transferir residentes apenas para tentar cumprir artificialmente as metas de pessoal.\",\n    \"Penalizações financeiras e auditorias trimestrais para estabelecimentos que não cumpram as regras.\"\n  ],\n  \"category\": [\"Health\", \"Labor\"]\n}"
    }
  ]
}