The Centers for Medicare & Medicaid Services (CMS) is preparing to repeal the minimum staffing rule for nursing homes, a rule originally finalized in 2024 after decades of advocacy from resident advocates, families, and elder justice organizations.
The repeal is currently under review by the White House Office of Management and Budget and, if issued as an interim final rule, could take effect immediately without any public comment period. This could lead to an increase in nursing home accidents and injuries.
What Was the Staffing Rule?
The staffing rule required:
- A registered nurse on duty 24/7 in every nursing home.
- At least 3.48 hours of nursing care per resident, per day.
These minimums were intended to set a floor – not a ceiling – for nursing home staffing. Facilities with residents who had higher care needs would have been required to provide even more hours of direct care.
CMS also tied the staffing rule to new transparency requirements, including cost reporting, to ensure Medicaid dollars were being spent on direct care workers rather than profits or overhead.
Why the Rule Is Being Repealed
Provider groups like the American Health Care Association (AHCA) and LeadingAge lobbied fiercely against the rule, claiming it was unworkable due to workforce shortages. They filed lawsuits, and two federal courts struck down parts of the rule, finding that CMS had exceeded its authority.
Congress then delayed implementation until 2034, citing an estimated $22 billion in compliance and enforcement costs. With repeal now on the table, the rule’s future looks grim.
AHCA celebrated the news, saying repeal would “safeguard access to care for millions of seniors” and allow providers to work with Congress on “more supportive policies.”
Advocates Sound the Alarm
But resident advocates strongly disagree. Consumer Voice, a leading national advocacy organization for long-term care residents, warned that repealing the staffing rule will “result in the deaths of tens of thousands of nursing home residents” and strip away what could have been one of the most important protections in nursing home history.
The group points to CMS’s own estimates that the staffing rule would have saved 13,000 lives every year by preventing neglect, medical errors, and avoidable injuries like bedsores, falls, and infections.
Consumer Voice also emphasized that the repeal would happen without any opportunity for families, residents, or the public to weigh in:
“Make no mistake, rescission of this rule will result in the deaths of tens of thousands of nursing home residents, perpetuate poor care in nursing homes, and lead to incalculable harm to our country’s most vulnerable citizens.”
What This Means for Families
For families of nursing home residents, CMS’s decision is a devastating blow. Nursing Home understaffing is one of the leading causes of preventable harm in nursing homes. When there aren’t enough nurses and aides:
- Residents may not be safely toileted or fed.
- Bed alarms and call lights go unanswered.
- Falls, infections, and medication errors increase.
- Residents suffer neglect, decline, and even death.
Repealing the staffing rule sends a clear message: nursing home operators’ financial concerns are being prioritized over resident safety.
OMP’s Commitment
As Nursing Home Abuse and Neglect Lawyers, we know that understaffing is at the root of so many tragedies that occur in long-term care facilities. Families trust these facilities to provide basic safety and dignity. When corporations fail to staff adequately and residents are harmed, we hold them accountable.
As OMP President Donna MacKenzie explains:
“Families deserve to know their loved ones are cared for by trained professionals in safe, well-staffed environments. Repealing the staffing rule is a step backward that puts vulnerable residents at risk. Our firm will continue to fight for accountability and justice when nursing homes choose profits over people.”
What You Can Do
- Stay informed: Follow updates from Consumer Voice and other resident advocacy groups.
- Ask questions: When choosing a nursing home, ask about staffing levels and demand transparency.
- Hold facilities accountable: If your loved one suffers harm due to understaffing, seek legal guidance.
If your loved one has been harmed in a nursing home because of neglect or understaffing, call Olsman MacKenzie Peacock at 1-800-366-8653. Our attorneys are here to help you get answers and justice.