1. Short title This Act may be cited as the Quality Care for Nursing Home Residents Act of 2019 . 2. Minimum nurse staffing requirements for skilled nursing facilities under Medicare program and nursing facilities under Medicaid program (a) Medicare (1) In general Subparagraph (C) of section 1819(b)(4) of the Social Security Act ( 42 U.S.C. 1395i–3(b)(4) ) is amended— (A) in clause (i)— (i) by amending the clause heading to read as follows: General requirements before 2020 ; and (ii) by striking Except as provided in clause (ii), and inserting Except as provided in clause (iii), with respect to skilled nursing facility services provided before January 1, 2020, ; (B) by redesignating clause (ii) as clause (iii); and (C) by inserting after clause (i) the following new clause: (ii) General requirements after 2019 (I) In general With respect to skilled nursing facility services provided on or after January 1, 2020, a skilled nursing facility must— (aa) provide nursing services that are sufficient to meet the nursing needs of its residents on a 24-hour basis, to be divided into day shifts, evening shifts, and night shifts; (bb) provide for minimum nurse staffing levels with respect to each such shift, in accordance with this clause; and (cc) ensure that, in carrying out items (aa) and (bb), a total minimum of 4.1 hours of care is provided per resident per day, with 0.75 hours of care of such total minimum provided by a registered professional nurse, 0.54 hours of care of such total minimum provided by a licensed practical nurse, and 2.81 hours of care of such total minimum provided by a nurse aide (as defined in paragraph (5)(F)). (II) Day shifts With respect to a day shift, the skilled nursing facility must have— (aa) at least 1 registered professional nurse for every 28 residents, with a minimum of 0.29 hours of care provided per resident during each such shift; (bb) at least 1 licensed practical nurse for every 40 residents, with a minimum of 0.20 hours of care provided per resident during each such shift