Nursing home staffing rule rescinded, evoking relief and regret

After much anticipation, the federal government has rescinded minimum staffing requirements at nursing homes and long-term care facilities.

The Department of Health & Human Services announced the decision earlier this week. Health systems and operators of nursing homes and long-term facilities had opposed the staffing requirements, calling them costly and unrealistic at a time when it’s already difficult to hire enough staff.

Health systems cheered the government’s decision, which was widely expected, but advocates for seniors had said the staffing requirement would improve the safety of nursing homes.

Health & Human Services Secretary Robert F. Kennedy Jr. said, “Rigid, one-size-fits-all mandates fail patients.

“This Administration will safeguard access to care by removing federal barriers—not by imposing requirements that limit patient choice,” he said in a statement.

The health department said the rule put unfair burdens on rural operators, and reflected the Trump administration’s push to reduce regulations.

Charlene MacDonald, executive vice president of public affairs for the Federation of American Hospitals, applauded the announcement.

“This repeal rightfully reflects the reality that long-term care facilities are facing challenging workforce shortages,” MacDonald said in a statement. “Rolling back this regulatory burden recognizes flexible staffing coupled with innovation improves the quality of care, reduces staff burnout, and keeps facilities' doors open so patients can access the care they need when they need it."

Stacey Hughes, executive vice president of government relations and public policy for the American Hospital Association, said operators of nursing homes should have the judgment to meet their staffing needs. She also said some facilities wouldn’t survive if they had to meet the minimum requirements.

“The AHA has repeatedly raised concerns that the requirements could exacerbate workforce shortages, lead to facility closures and jeopardize access to care, especially in rural and underserved communities that often do not have the workforce levels to support these requirements,” Hughes said in a statement.

​The American Health Care Association and the National Center for Assisted Living, which represents nursing homes and long-term care facilities, had long fought the federal rule.

Clif Porter, president and CEO of the AHCA/NCAL, called the health department’s decision a victory for seniors.

“This unrealistic regulation threatened to close nursing homes and displace vulnerable residents,” Porter said in a statement posted on X.

But advocates for seniors said minimum staffing requirements would improve the safety of vulnerable residents in nursing homes and long-term facilities.

The provisions called for nursing homes and other long-term facilities to have a registered nurse onsite 24 hours per day. The rule would also have called for every resident to get .55 hours of care from a registered nurse and 2.45 hours of care from a nurse’s aide every day.

The National Consumer Voice for Quality Long-Term Care described the staffing requirements as “the most significant increase in protections for nursing home residents in decades.”

The group said it “strongly condemns” the health department dropping the rule.

“The minimum staffing rule was estimated to save 13,000 lives annually and enhance the quality of care and life for nursing home residents,” the group said.

The AARP also had pushed for the minimum staffing requirement, which had been finalized under the Biden administration. The AARP had opposed an earlier proposal to delay the regulations until 2035.

“AARP strongly supported the long-overdue minimum nursing home staffing standards rule,” the group said in a letter to Congress in the spring.