CMS repeals minimum staffing requirements for skilled nursing, long-term care facilities

The Centers for Medicare & Medicaid Services Dec. 2 repealed the minimum staffing requirements for nursing homes that participate in Medicare and Medicaid that the agency adopted in 2024. Specifically, CMS is removing the requirements for nursing homes to provide a minimum of 3.48 hours of nursing care per resident day, including 0.55 hours of care from a registered nurse per resident day and at least 2.45 hours of care from a nurse aide per resident day. The agency is also removing the requirement for nursing homes to have 24/7 onsite RN services and is reinstating its prior policy requiring facilities to use the services of an RN for at least eight consecutive hours a day, seven days a week and to designate an RN to serve as the director of nursing on a full-time basis except when waived. The facility assessment requirements adopted in the 2024 final rule will remain in place. CMS’ actions are consistent with the budget reconciliation bill enacted in July, which imposed a 10-year implementation and enforcement moratorium on the minimum staffing requirements for long-term care facilities. 
 
“The AHA applauds CMS’ repeal of the misguided minimum staffing requirements for long-term care facilities,” said Stacey Hughes, AHA executive vice president for government relations and public policy, in a statement shared with media. “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. The AHA appreciates the administration’s recognition that safe staffing of any health care facility has always been about clinical judgment and flexibility to meet continually evolving patient needs rather than meeting arbitrary, one-size-fits-all numbers set by regulation.”