The Centers for Medicare and Medicaid Services (CMS) today released an interim final rule (IFR) that repeals parts of the Biden Administration’s staffing mandate. Specifically, the IFR rescinds implementation of the 24/7 on-site registered nurse requirement, as well as the specific minimum number of nursing hours per resident per day requirements.
Nursing home providers are still required to comply with the facility assessment provision, which has already gone into effect. We will continue to encourage the Administration to rescind duplicative reporting requirements that do not support quality improvement. This rule also does not impact the Medicaid Institutional Transparency provisions that were previously finalized.
This rule takes effect 60 days after the date of publication in the Federal Register. There is a 60-day comment period, with all comments due by February 2, 2026.
This IFR is another confirmation that the federal staffing mandate is over. It follows two U.S. District Court decisions earlier this year—including AHCA’s case in the Northern District of Texas—which ruled that CMS exceeded its authority in setting standards beyond what Congress enacted. These rulings were then upheld when the U.S. Department of Justice withdrew their appeals in September. This prevents future administrations from issuing such a regulation later. The One Big Beautiful Bill Act passed by Congress this summer also included a 10-year moratorium on implementing the minimum staffing requirements in the rule. Even CMS conceded, in the IFR, that the staffing requirements, as finalized, imposed a one-size-fits-all policy that would have resulted in closures and access barriers in rural and tribal communities.
AHCA/NCAL has remained committed to fighting the federal staffing mandate from the very beginning and will continue to advocate for practical solutions that support building a strong long term care workforce and the continued delivery of high-quality care for our residents.