In a major shift for long-term care, CMS has signaled its intent to repeal the federal minimum staffing standards for nursing homes.
In a major shift for long-term care, the Centers for Medicare & Medicaid Services (CMS) has signaled its intent to repeal the federal minimum staffing standards for nursing homes.
The staffing mandate, finalized in 2024, required facilities to provide 24/7 registered nurse (RN) coverage and meet minimum nursing hours per resident day. These requirements faced significant pushback from providers citing workforce shortages, as well as legal challenges from industry associations.
In April 2025, a federal judge in Texas struck down the mandate, ruling that CMS exceeded its statutory authority in imposing nationwide staffing ratios. Now, CMS has submitted an Interim Final Rule to the Office of Management and Budget titled “Medicare and Medicaid Programs; Repeal of Minimum Staffing Standards for Long-Term Care Facilities.” This move signals CMS’s intent to formally remove the rule from federal regulation.
What This Means for Providers
- No minimum RN coverage mandate: The requirement for 24/7 RN presence would be rescinded.
- No fixed staffing ratios: Facilities would not be bound by the previously finalized hours-per-resident-day standards.
- Compliance uncertainty: Until the repeal is formally published and effective, providers should continue to monitor CMS communications and surveyor guidance.
Industry Impact
The repeal would relieve facilities of regulatory obligations many argued were unworkable amid ongoing workforce shortages. However, it also raises questions about how CMS will continue to address staffing concerns, given the direct link between staffing levels and quality of care outcomes.
Bottom Line:
If finalized, this repeal will represent a dramatic policy reversal by CMS, effectively nullifying the staffing mandate less than a year after it was finalized. Providers should watch closely for the official publication of the Interim Final Rule and be ready to adjust compliance strategies accordingly.
