Washington, DC — The Department of Health and Human Services on Monday formally repealed major portions of the federal minimum staffing rule for nursing homes, unwinding a policy that had been at the center of contentious court battles and congressional negotiations since its release in 2024.
The decision aligns HHS with the recently enacted One Big Beautiful Bill Act, which halted enforcement of the staffing mandate for nine years and effectively nullified the rule’s hourly staffing and registered nurse standards. The agency acknowledged that repeal was necessary to bring federal regulations into compliance with the new law.
In a statement, HHS framed the reversal as a shift toward “practical, sustainable approaches” intended to support facility operations while expanding opportunities for communities to weigh in on future reforms.
CMS Administrator Mehmet Oz echoed that theme, saying the agency must pursue quality improvements that account for severe workforce shortages nationwide.
“Every American deserves access to compassionate, high-quality care,” Oz said. “But 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.”
Long-debated mandate falls away
The original 2024 rule required Medicare- and Medicaid-certified nursing homes to deliver at least 3.48 hours of daily nursing care per resident. That included 0.55 RN hours and 2.45 nurse aide hours, along with a mandate for 24/7 onsite RN coverage. Providers argued the standards were unattainable given a nationwide labor shortage.
Courts ultimately agreed. In a series of rulings brought by industry groups and more than 20 state attorneys general, judges struck down the RN requirements and staffing minimums, citing the workforce crisis and questions about the rule’s feasibility.
On Monday, HHS acknowledged that the standards “disproportionately burdened rural and underserved communities already grappling with critical healthcare workforce shortages.”
HHS Secretary Robert F. Kennedy Jr. said the administration aims to “safeguard access to care by removing federal barriers — not by imposing requirements that limit patient choice.”
Some elements may remain intact
While the staffing mandates are now rescinded, Democrats succeeded in preserving several components of the 2024 rule related to oversight and reporting. Those include updated assessment and transparency tools intended to help facilities evaluate whether they have adequate staffing.
Lawmakers last month pressed CMS for clarity on the future of those provisions — particularly the new facility assessment process, in use since August 2024, and Medicaid Institutional Payment Transparency Reporting requirements meant to reveal how much of nursing home Medicaid funding is spent on direct care workers and support staff.
CMS had not published formal repeal details in the Federal Register as of Monday morning.
This is a developing story. Additional updates are expected.
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