OPINION:
Before serving in the halls of Congress, I walked the halls of primary care clinics and nursing homes, caring for our nation’s Greatest Generation. From routine checkups to treating patients living with dementia and complex chronic conditions, I had the privilege of serving seniors at every stage of health. That experience is one of the many reasons I entered public service. I saw firsthand how our seniors are directly impacted by the lack of older adult advocacy on the federal level and I knew we could do better.
During my time in the Virginia State Senate, I introduced Senate Bill 1149 to establish minimum staffing ratios for certified nursing assistants (CNAs) and licensed practical nurses (LPNs), and to require a registered nurse (RN) to be onsite 24 hours a day in nursing homes. The evidence is clear: staffing levels matter. A National Academies of Sciences, Engineering and Medicine study on nursing staff in hospitals and nursing homes found that higher RN hours per patient were consistently and significantly associated with better outcomes including lower mortality rates, improved patient capacity for self-care and a greater likelihood of timely discharge.
Additional research reinforces this conclusion. A study published in the National Institutes of Health National Library of Medicine in August 2025 examined state variations in staffing ratios following implementation of the federal minimum staffing rule. It found that stronger state staffing standards correlated with higher nursing home quality ratings. However, the study also highlighted that many facilities across the country struggled to meet the new federal requirements underscoring the serious workforce shortages facing our health care system.
The shortage of health care professionals is deeply concerning, especially as America’s aging population continues to grow. Since coming to Congress, expanding and strengthening the health care workforce has been one of my top priorities. We must make the profession more accessible for young people entering the workforce while easing the burden on the nurses currently delivering care.
That’s why I supported the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, which funds programs to address burnout and support the mental health and wellbeing of health care providers nationwide. I was proud to see this legislation included in this year’s consolidated appropriations bill so that health care workers receive the support they deserve.
I have also supported legislation to expand workforce capacity and reduce unnecessary barriers to care. H.R. 1317, the ICAN Act, would allow nurse practitioners and physician assistants to practice to the full extent of their training under Medicare and Medicaid. H.R. 392, the PRECEPT Nurses Act, would provide up to a $2,000 tax credit for nurse preceptors who train the next generation of nurses, thus helping strengthen the workforce pipeline.
Additionally, I have made it a priority to advocate for recognizing post-baccalaureate nursing programs as professional degrees. I have sent multiple letters to the Department of Education expressing concern about the exclusion of advanced practice nurses from this designation and the long-term consequences it could have on workforce recruitment. If we are serious about addressing staffing shortages and meeting growing patient demand, we must encourage Americans to enter the nursing profession not create additional barriers.
Nursing home reform begins with supporting the people who provide the care. Nurses are the backbone of our health care system. If we want better outcomes for seniors and patients, we must ensure there are enough well-trained professionals on the floor to provide timely, compassionate care. That means strengthening the workforce pipeline, supporting provider well-being and reducing unnecessary administrative burdens that pull nurses away from their patients.
We can protect seniors, support nurses, and be responsible stewards of taxpayer dollars, all at the same time but only if we build a system that puts patient care first. Our seniors deserve nothing less.
• Rep. Jen Kiggans, a Republican, represents Virginia’s 2nd Congressional District in the U.S. House of Representatives. She serves on the House Armed Services, Veterans’ Affairs and Natural Resources committees. Prior to public office, she served 10 years as a U.S. Navy helicopter pilot, flying H-46 and H-3 helicopters and completing two deployments to the Persian Gulf, and then worked in the health care system as a geriatric nurse practitioner.
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