WASHINGTON, D.C. — The U.S. Department of Health and Human Services (HHS) on Tuesday repealed key portions of a federal nursing home staffing rule, a move officials say will ease pressure on long-term care facilities—particularly those in rural and Tribal communities struggling with workforce shortages.
The repealed provisions were part of the Minimum Staffing Standards for Long-Term Care Facilities rule finalized by the Centers for Medicare & Medicaid Services (CMS) in 2024. HHS determined the previous administration’s requirements placed disproportionate strain on facilities and risked reducing patient access to care.
The decision aligns with the One Big Beautiful Bill Act and is intended to promote what HHS calls “practical, sustainable approaches” to improving nursing home care.
“Safe, high-quality care is essential, but rigid, one-size-fits-all mandates fail patients,” said HHS Secretary Robert F. Kennedy, Jr. “This Administration will safeguard access by removing federal barriers—not by imposing requirements that limit patient choice.”
CMS Administrator Dr. Mehmet Oz emphasized that the previous rule ignored the realities facing health systems already struggling to meet demand.
“We cannot improve outcomes while overlooking the challenges rural and underserved communities face,” Oz said.
The 2024 rule required facilities participating in Medicare and Medicaid to provide at least 3.48 hours of daily nursing care per resident, including specific minimums for registered nurses and nurse aides, and mandated a 24/7 onsite RN presence. Many rural and Tribal facilities warned the staffing mandates were impossible to meet given existing shortages.
Tribal leaders also raised concerns that they were not adequately consulted during the initial rulemaking process, despite the significant impact on long-term care operations in Indian Country.
“The Oneida Nation appreciates Secretary Kennedy for recognizing the unique staffing challenges in tribal communities and rescinding a rule that would have severely limited our ability to care for our elders,” said Oneida Nation Chairman Tehassi Hill.
The repeal supports President Trump’s Executive Order Unleashing Prosperity Through Deregulation, directing agencies to eliminate burdensome regulations and return more authority to local communities.
HHS says it remains committed to improving nursing home quality while ensuring policies do not restrict access to care for rural and Tribal populations.
