Dive Brief:
- The Trump administration repealed a Biden-era rule on Tuesday that would have required nursing homes to increase their staffing and have a registered nurse on premise around the clock.
- The Biden administration introduced the rule in 2023 and finalized it in April 2024. However, lawmakers and nursing homes fought the rules, saying the industry could not afford to increase staffing among worker shortages. In April, a federal judge sided with trade organizations and struck down the rule, saying HHS had overstepped its authority in issuing it.
- Now, HHS has repealed the rule, saying it would disproportionately burden rural and Tribal communities. “Safe, high-quality care is essential, but rigid, one-size-fits-all mandates fail patients,” said HHS Secretary Robert F. Kennedy Jr. in a statement. “This Administration will safeguard access to care by removing federal barriers—not by imposing requirements that limit patient choice.”
Dive Insight:
The staffing rule was intended to address quality concerns brought to light during the COVID-19 pandemic, which found inadequate staff could lead to more falls, illness and lower patient health outcomes. The Biden administration cited research that found increased staffing levels were associated with better patient health.
The final rule would have required nursing homes that receive Medicare and Medicaid funding to have at least one registered nurse on-site 24 hours a day, as well as total nurse staffing of 3.48 hours per resident per day.
Industry groups argued those standards were too onerous, especially in light of ongoing staffing shortages.
Analyses from the CMS found 79% of nursing homes would have to increase hiring to meet the 3.48 hours of patient care per resident, per day requirement. KFF predicted 81% of facilities would have to hire additional staff.
Implementing the rule could also cost the industry anywhere from $1.5 billion to $6.8 billion, according to the CMS.
Since President Donald Trump took office in January, the administration has cooled on enforcing the rules. In July, Trump signed the One Big Beautiful Bill Act into law, which included a 10-year pause on enforcing the mandate.
“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,” CMS Administrator Dr. Mehmet Oz said in a release. “This repeal is a step toward smarter, more practical solutions that truly work for the American people.”
