The Centers for Medicare & Medicaid Services (CMS) is taking steps to rescind the controversial federal staffing mandate for nursing homes.
The White House Office of Management and Budget (OMB) is reviewing an Interim Final Rule from CMS with the title “Repeal of Minimum Staffing Standards for Long-Term Care Facilities,” according to an online posting of regulatory actions currently under review. Though details of the rule are not publicly available, its title suggests that CMS is moving to officially withdraw a measure that already has been largely dismantled through legal and Congressional action.
The staffing mandate was first put forward by the Biden administration in 2023, with a final rule issued last year. However, the nursing home sector fought against the mandate with vehement advocacy and legal action, including a lawsuit involving the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) and LeadingAge, two major provider organizations.
Earlier this year, a Texas judge struck down key provisions of the final rule, including the requirement to have around-the-clock registered nurse staffing and the minimum staffing threshold of 3.48 hours per resident day. More recently, the One Big Beautiful Bill Act (OBBBA) included a 10-year moratorium on the mandate.
“Some combination of these forces” – regulatory, statutory and judicial – likely led to CMS’ decision to rescind the rule and put a final end to the matter, according to Linda Couch, SVP, policy and advocacy at LeadingAge.
“We are beyond eager to have the minimum staffing final rule repealed and are pleased to see apparent action under review at the Office of Management and Budget to do so quickly through an interim final rule,” Couch said in a statement emailed to SNN. “ … Because staff is critical to quality care, LeadingAge will continue to focus on the priority issue of expanding the aging services workforce.”
The American Health Care Association also is continuing to focus on efforts to build a stronger workforce. AHCA on Tuesday announced the launch of a “Caregivers for Tomorrow” effort, calling on advocates to push for a variety of initiatives meant to “strengthen and expand the long term care workforce through innovative, sustainable solutions.”
Specifically, AHCA is promoting actions such as developing incentive programs such as loan forgiveness and tax credits to attract workers to long-term care; expansion of career ladders within the industry; expanding telehealth flexibilities and other technology-related policies to alleviate caregiver burnout; and immigration reform that would expand legal pathways into long-term care careers.
Regarding the staffing mandate, AHCA is “grateful” to see CMS taking steps to rescind the rule, association spokeswoman Rachel Reeves said in a statement emailed to SNN.
“Congress and the courts have spoken on this issue, and it’s encouraging that the Administration appears to be following suit,” Reeves stated. “Not only do we need to ensure that federal regulators do not exceed their authority, but rescinding this rule will also safeguard access to care for millions of seniors for years to come. We welcome the opportunity to work with CMS and Congress on pursuing more supportive policies to strengthen our workforce and enhance quality care in America’s nursing homes.”
