Today, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule rescinding part of the minimum staffing rule in nursing homes, the most significant increase in protections for nursing home residents in decades. CMS cited Congress’s recent postponement of the rule’s implementation until 2035 and two federal court cases that found parts of the rule to be invalid as reasons for the rule’s rescission. But CMS also contradicted itself by claiming the rule was no longer appropriate, despite promulgating the rule last year and defending it in the court cases. The interim final rule rescinds the minimum hours per resident day requirements (0.55 Registered Nurse, 2.45 nurse aide, and 3.48 total nurse staffing) and provisions requiring a registered nurse onsite 24 hours, 7 days per week. It does not, however, rescind other portions of the rule regarding enhanced facility assessment requirements, and provisions requiring that states disclose Medicaid spending on care staff.
In the preface to the rule change, CMS cited nursing home industry talking points regarding a lack of workers and concerns about the impact on rural facilities, ignoring the provisions that would allow significant exceptions to compliance with the staffing standards. Importantly, CMS’s staffing study conducted prior to promulgation of the final rule last year demonstrated that staffing in rural facilities was comparable to urban facilities. Nor does the preface of the rule address the real challenge to the nursing home workforce: job quality. CMS’s data shows that the average annual turnover rate of nursing home direct care staff is 50% nationally, a key factor in understaffing and lower quality.
Consumer Voice strongly condemns yesterday’s announcement. The minimum staffing rule was estimated to save 13,000 lives annually and enhance the quality of care and life for nursing home residents. The interim final rule was published in the Federal Register today and goes into effect 2/2/2026. CMS is accepting comments on the rule until that date. Consumer Voice will be submitting comments and will provide tools for others to comment.
Despite this disappointing announcement, we must all continue to fight for the dignity, safety, and well-being of nursing home residents and those who care for them.
