Ahead of a potential CMS proposed rule aimed at reducing administrative burdens across health care – including nursing homes – that could be released in August, providers are urging the agency to standardize surveyor training, Medicare medical reviews and Minimum Data Set requirements.

They argue the changes would improve consistency, reduce administrative burdens and allow nursing homes to devote more resources to resident care and quality improvement.

Currently in the early stages of development, the potential rule is being shaped by the Trump administration’s April request for information (RFI), which sought recommendations to reduce regulatory and administrative burdens in response to a January 2025 White House executive order on deregulation, according to nursing home stakeholders who spoke with Skilled Nursing News.

LeadingAge, the largest association of nonprofit providers of post-acute care providers, submitted its comments to the Department of Health and Human Services (HHS) in June on home health, hospice, Medicare Advantage, PACE and nursing home regulations, including proposals to streamline reporting and eliminate duplicative requirements.

“[W]e outlined several recommendations across provider settings that would support the healthcare workforce by providing flexibility in staffing and operations, reduce administrative burden by streamlining reporting and data collection, and give patients better access to care in a more timely manner,” Jodi Eyigor, VP of health policy at LeadingAge, said in an emailed statement to SNN. “Changes like these will go a long way in empowering healthcare providers, including our nonprofit and mission-driven members, to deliver the high-quality care our nation’s older adults deserve.”

The potential rule, titled “Cutting Administrative Requirements for Excellence in Patient Care,” is currently under review for publication at the White House Office of Management and Budget (OMB). As is typical during the preliminary stages before a proposed rule is officially published, CMS has not yet issued updates to stakeholders.

The Notice of Proposed Rulemaking (NPRM) states that such a rule hopes to ease direct patient care by easing certain administrative burdens on providers, while noting that CMS has been reviewing possible avenues of deregulation.

“This proposed rule would enhance direct patient care by modernizing the Conditions of Participation, Conditions for Coverage, and Requirements for Medicare- and Medicaid-participating providers and suppliers, reducing burden and increasing flexibility to deliver high quality care,” the OMB entry notes. “CMS identified obsolete, outdated, and excessively burdensome regulations that can be eliminated or reformed to enhance the effectiveness of facility operations and services and free up resources that healthcare providers could otherwise use to improve patient health and safety.”

The American Association of Post-Acute Care Nursing, or AAPACN, which represents more than 20,000 post-acute care nurses and professionals, has also submitted recommendations following the executive order’s RFI, according to Senior Curriculum Development Specialist Jessie McGill, who said her organization is emphasizing that reducing administrative burden should not come at the expense of resident safety or program integrity, she said.

“Rather, we encouraged CMS to modernize regulations that no longer reflect today’s healthcare environment, eliminate duplicative requirements, and simplify overly complex processes so long-term care professionals can spend more time caring for residents and less time navigating paperwork,” she told SNN.

At this time, AAPACN has not received any additional information from CMS regarding the deregulation rule or any updates on the status of its feedback submitted in response to the RFI.

“We have not been informed which, if any, of the recommendations submitted by AAPACN and other stakeholders in response to the Request for Information will be incorporated into future rulemaking,” McGill said.

The nurses’ association urged CMS to reduce administrative burdens on skilled nursing staff by simplifying beneficiary notices, modernizing Medicare requirements such as the three-day hospital stay rule, streamlining consolidated billing and reducing duplicative reporting, McGill said.

The organization called for improving the consistency and transparency of survey and audit processes urging greater consistency, McGill added.

“We encouraged CMS to standardize surveyor training and interpretation of regulations, improve reviewer competency during Medicare medical reviews, and reinforce national standardization of the Minimum Data Set rather than allowing varying state-specific documentation requirements,” McGill noted. “We believe these changes would reduce confusion, decrease unnecessary appeals and corrective actions, and allow facilities to devote more resources to quality improvement rather than administrative compliance.”

Finally, AAPACN is pushing for more transparency in the Skilled Nursing Facility Quality Reporting (QRP) and Value-Based Purchasing (VBP) programs and the elimination of redundant validation reviews of documentation already examined through other Medicare oversight processes, she said.

‘A positive’

Holly Harmon, senior vice president of quality, regulatory and clinical services at the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL), lauded the possible regulatory reform effort.

“AHCA looks forward to reviewing the proposed rule once it is issued and appreciates CMS’ commitment to prioritizing patients over paperwork. We have submitted detailed recommendations on a better way to make the nursing home oversight system more effective and efficient while upholding accountability and transparency, and we hope to see many of those recommendations in the forthcoming rule,” Harmon noted in an emailed statement to SNN. “It’s time to develop a more rational regulatory approach that drives quality improvement, and we look forward to working with the agency to make additional progress in the near future.”

Meanwhile, LeadingAge leaders also welcomed the deregulation push as an ongoing step in the right direction.

“Both the current and prior administrations under President Trump have demonstrated an interest in and commitment to addressing regulatory burden-efforts that we’ve largely supported in the past and continue to view as positive developments,” Eyigor said.

As for AAPACN, McGill said her organization is very appreciative of the federal agencies’ efforts to find ways to reduce burdens so nurses can spend more time at the bedside.

“We are hopeful it will include some of the practical changes AAPACN recommended to modernize regulations, reduce unnecessary administrative burden, and allow long-term care professionals to spend more time caring for residents while maintaining resident safety and Medicare program integrity,” McGill said.