The mandate, put into place under the Biden administration, burdened facilities, especially those serving rural and Tribal communities, HHS says.
On Tuesday, the Department of Health and Human Services repealed a nursing home staffing mandate put in place under the Biden administration.
The final rule issued in 2024 burdened facilities, especially those serving rural and Tribal communities, jeopardizing access to care, HHS said.
The decision is in alignment with the One Big Beautiful Bill Act, HHS said.
WHY THIS MATTERS
Tribal communities had expressed concern that they were not adequately consulted about the nursing staffing requirements in the original rulemaking process. The rule would have impacted long-term care facilities operating in Indian Country, they said, according to HHS.
HHS said it is also actively working to ensure that future policymaking includes Tribal consultation that upholds Tribal sovereignty.
“The Oneida Nation appreciates [HHS] Secretary [Robert F.] Kennedy for recognizing the unique staffing challenges in tribal communities and rescinding a rule that would have severely limited our ability to care for our elders,” said Chairman Tehassi Hill of the Oneida Nation.
Numerous providers expressed dissatisfaction with the rule.
The American Hospital Association said the final rule was “onerous,” given nursing homes already face staffing challenges.
The vast majority of nursing facilities would need to hire more staff to comply with the final rule, KFF said when the rule was released. Fewer than one in five nursing facilities meet the minimum staffing standards of the final rule, KFF said. Nearly 60% of facilities met the overall staffing requirement of 3.48 hours of nursing care per resident day, which had been set as the interim requirement in the rule, the report said.
The Biden administration initiated the rule after the government found that more than 40% of Americans who died during the COVID-19 pandemic lived in nursing homes. An estimated 1.2 million residents receive care in Medicare- and Medicaid-certified nursing homes.
The repeal advances President Donald Trump’s executive order Unleashing Prosperity Through Deregulation, which was released in January 2025, HHS said. It directs federal agencies to eliminate unnecessary regulatory burdens and return decision-making power to communities and individuals.
THE LARGER TREND
The Centers for Medicare and Medicaid issued the final rule in April 2024.
Nursing homes participating in Medicare and Medicaid programs were required to provide residents with a minimum total of 3.48 hours of nursing care per day, which included at least 0.55 hours of care from a registered nurse per resident per day and 2.45 hours of care from a nurse aide per resident per day.
Nursing homes were required to have a registered nurse on site 24 hours per day, seven days per week.
In May 2024, the American Health Care Association, the Texas Health Care Association, Arbrook Plaza, Booker Hospital District, and Harbor Lakes Nursing and Rehabilitation Center brought a lawsuit against the final rule in federal court in the Northern District of Texas. The final rule exceeded statutory authority, the plaintiffs said.
This April, the judge in Texas blocked the nursing home staffing rule.
The One Big Beautiful Bill Act passed by Congress this summer included a 10-year moratorium on implementing the minimum staffing requirements, said AHCA and NCAL, the American Health Care Association and the National Center for Assisted Living.
ON THE RECORD
CMS Administrator Dr. Mehmet Oz said: “At CMS, our mission is not only to improve outcomes, but to ensure those outcomes are achievable for all communities. We cannot meet that goal by ignoring the daily realities facing rural and underserved populations. This repeal is a step toward smarter, more practical solutions that truly work for the American people.”
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