WASHINGTON, D.C. – The U.S. Department of Health and Human Services has repealed key provisions of a federal rule that set nationwide minimum staffing requirements for long-term care facilities, a move the agency says will ease burdens on rural and Tribal nursing homes and protect access to care.
The staffing standards, finalized in 2024 by the Centers for Medicare & Medicaid Services, required facilities participating in Medicare and Medicaid to provide at least 3.48 hours of nursing care per resident per day. The rule also mandated that a registered nurse be onsite around the clock. HHS determined these requirements created challenges for facilities already facing workforce shortages, particularly in rural and Tribal communities.
In its announcement, the agency said the repeal aligns with the One Big Beautiful Bill Act and supports an effort to adopt more flexible, practical approaches to improving care. HHS officials emphasized that high-quality care remains a priority but argued the previous federal mandates did not account for the varying capacities of facilities across the country.
“Safe, high-quality care is essential, but rigid, one-size-fits-all mandates fail patients,” HHS Secretary Robert F. Kennedy Jr. said in the release. CMS Administrator Dr. Mehmet Oz echoed that point, noting the staffing rule did not reflect the realities of underserved areas and that the repeal allows for “smarter, more practical solutions.”
HHS also cited concerns from Tribal nations, which said the original rulemaking did not adequately include Tribal consultation despite the potential effects on long-term care services in Indian Country. The agency said future policymaking will incorporate more robust engagement with Tribal governments.
The decision supports a broader deregulation effort under President Trump’s “Unleashing Prosperity Through Deregulation” executive order, which directs federal agencies to reduce regulatory burdens and return decision-making authority to local communities.
HHS stated it remains committed to improving nursing home quality while ensuring that regulatory requirements do not limit access to long-term care in rural and Tribal regions.
