Raleigh, NC — North Carolina Attorney General Jeff Jackson has joined a coalition of 18 state attorneys general urging federal health officials to restore minimum staffing standards for nursing homes, warning that rolling back those rules could leave seniors at greater risk of neglect and preventable harm.
In a comment letter to U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz, the attorneys general asked the federal government to reinstate protections they say were designed to ensure enough nurses are available to safely care for residents in long-term care facilities.
What the standards required
The group is calling for a return to federal staffing protections that set baseline requirements for nurse staffing in nursing homes—measured in nursing hours per resident per day—and mandated around-the-clock on-site registered nurse coverage. The standards also established minimum staffing levels for certified nursing assistants, who provide much of the hands-on daily care in skilled nursing facilities.
Supporters of the staffing requirements have argued that higher staffing levels are tied to better outcomes for residents, including fewer adverse events and fewer hospitalizations. The attorneys general pointed to estimates that stronger staffing requirements could reduce costly medical emergencies—potentially saving the Medicare program up to $465 million by preventing avoidable trips to the hospital.
Concerns after federal rollback
The coalition’s letter comes after changes in federal policy that reversed key parts of those staffing standards. The attorneys general said the shift undercut safeguards meant to protect some of the country’s most vulnerable patients—many of whom rely on Medicare and Medicaid to cover long-term care.
In the letter, the attorneys general asked federal officials to adopt replacement rules that ensure adequate staffing levels, strengthen resident protections, and help deter Medicare and Medicaid fraud.
“Placing a loved one in a nursing home is an act of profound trust,” Jackson said. “By removing staffing standards, we violate that trust and leave seniors vulnerable to neglect. We need federal rules to ensure that when a resident rings for help, there is actually a nurse available to answer.”
Who’s in the coalition
Alongside Jackson, the letter was signed by attorneys general from Arizona, California, Colorado, Delaware, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington.
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