Washington, D.C. — The U.S. Department of Health and Human Services (HHS) has officially repealed key nursing home staffing requirements that had been finalized in 2024 and were scheduled to take effect in early 2026. The rule, which would have required Medicare- and Medicaid-participating nursing homes to maintain a registered nurse on-site 24 hours a day and meet specified minimum staffing levels, will no longer be implemented.
The staffing standards established in the 2024 rule included minimum total nursing care hours per resident per day — 3.48 hours overall, 0.55 of which would come from a registered nurse — and the requirement for 24/7 registered nurse coverage. These provisions have now been removed by an interim final rule published by HHS and the Centers for Medicare & Medicaid Services (CMS).
The repeal is tied in part to legislative and legal developments. A provision in Public Law 119-21 bars CMS from implementing the 2024 minimum staffing standards until at least 2034, and portions of the rule had already been vacated in court challenges. In light of these constraints and concerns raised by providers about workforce shortages, HHS chose to rescind the unenforceable requirements and revert to prior staffing regulations.
HHS and some industry groups argued that the previous mandate could disproportionately burden facilities, particularly in rural and tribal areas where staffing shortages are more acute. The repeal is effective February 2, 2026, the same date the original rule was set to take effect.
The decision has drawn mixed reactions. Operators and hospital associations welcomed the rollback as reducing regulatory burdens amid ongoing workforce challenges. However, consumer advocates and some lawmakers have criticized the move, saying the staffing standards would have provided important protections for vulnerable residents.
At the same time, not all aspects of the 2024 staffing rule were eliminated: independent requirements for enhanced facility assessments tied to resident needs remain in place, though separate from the repealed staffing mandates.
