Trump administration repeals Biden-era nursing home staffing mandate

Diving brief:

• The Trump administration on Tuesday repealed a Biden-era rule that would have required nursing homes to increase their staffing levels and have a registered nurse on-site 24 hours a day.
• The Biden administration introduced the rule in 2023 and finalized it in April 2024. However, lawmakers and nursing homes have fought the rules, saying the industry cannot afford to increase its workforce due to a labor shortage. In April, a federal judge sided with professional organizations and struck down the rule, saying HHS exceeded its authority in issuing it.
• Today, HHS rescinded the rule, saying it would disproportionately burden rural and tribal communities. “Safe, high-quality care is essential, but rigid, one-size-fits-all mandates fail patients,” HHS Secretary Robert F. Kennedy Jr. said in a statement. “This administration will ensure access to care by removing federal barriers, not by imposing requirements that limit patient choice. »

Dive overview:

The staffing rule was intended to address quality issues highlighted during the COVID-19 pandemic, which revealed that inadequate staffing could lead to more falls, illnesses and poorer patient health outcomes. The Biden administration cited research that found increased staffing levels were associated with better patient health.

The final rule would have required nursing homes with Medicare and Medicaid funding to have at least one registered nurse on site 24 hours a day, as well as a total nursing staff of 3.48 hours per resident per day.

Industry groups have argued that these standards are too burdensome, especially in light of ongoing staffing shortages.

CMS analyzes found that 79% of nursing homes would need to increase staffing to meet the requirement of 3.48 hours of patient care per resident per day. KFF predicts that 81% of establishments would need to hire additional staff.

Implementing the rule could also cost the industry up to $1.5 billion. at $6.8 billion, according to the CMS.

Since President Donald Trump took office in January, the administration has shown restraint in enforcing the rules. In July, Trump signed the One Big Beautiful Bill Act into law, which included a 10-year pause in enforcement of the mandate.

“At CMS, our mission is not only to improve outcomes, but also to ensure that those outcomes are achievable for all communities. We cannot achieve this goal by ignoring the daily realities faced by rural and underserved populations,” CMS Administrator Dr. Mehmet Oz said in a statement. “This repeal is a step toward smarter, more practical solutions that actually work for the American people.”