Nursing homes get looser doctor rules—patient safety unclear
H.R. 7106 — Enhancing Skilled Nursing Facilities Act · Filed by Jennifer Kiggans (R-VA) · 1 cosponsor · Introduced Jan 15, 2026 · Referred to committee
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What it does
This bill expands who can supervise and provide care in Medicare and Medicaid-certified skilled nursing facilities by allowing nurse practitioners, physician assistants, and clinical nurse specialists to work independently or in collaboration with physicians, rather than requiring direct physician oversight. The changes apply across multiple care-delivery and certification sections, giving states flexibility to define supervision requirements.
Why we flagged it
The bill's core function is to relax physician-supervision requirements in nursing facilities by expanding the scope of practice for non-physician clinicians. While framed as 'enhancing' care delivery, the mechanism is fundamentally deregulatory—it removes a longstanding safeguard (physician oversight) and delegates authority to state law.
What the text implies
- Shifting supervision from physicians to lower-cost clinicians may reduce facility operating costs, potentially benefiting for-profit nursing home chains (DVA, GH) and their investors, while patient safety outcomes remain uncertain.
- Deferring to 'state law' creates a patchwork of supervision standards across the country, potentially allowing states with weaker regulations to reduce oversight further, creating a race-to-the-bottom dynamic.
The full analysis lists 4 implications of this text.
Who stands to gain
for-profit nursing home operators (DVA, GH); healthcare staffing agencies; nurse practitioner and physician assistant employers