The bill establishes new staffing requirements for nursing facilities in Iowa, mandating that they have sufficient personnel with the necessary competencies to ensure resident safety and well-being. It defines key terms such as "certified nurse aide training program," "nurse aide," "physician," and "registered nurse," and outlines the responsibilities of nursing facilities to provide 24-hour nursing care in accordance with individual resident care plans. Specifically, the bill requires a minimum of 3.48 hours of total nurse staffing per resident per day, which includes at least 0.55 hours for registered nurses and 2.45 hours for nurse aides. Additionally, it mandates that a registered nurse be on-site 24 hours a day and that facilities employ or contract with a physician to evaluate residents for wounds and infections weekly.

The bill also includes provisions for waivers of certain staffing requirements under specific conditions, such as when a facility demonstrates difficulty in recruiting staff or is located in a rural area with insufficient healthcare personnel. Facilities must notify residents and their representatives of any waivers granted. Furthermore, the bill requires nursing facilities to post staffing data daily, ensuring transparency regarding the number of staff and hours worked, and mandates that this information be accessible to residents and the public. The Department of Inspections, Appeals, and Licensing (DIAL) is tasked with adopting rules to implement these requirements.