An interim final rule repealing the nursing home minimum staffing standards was released to the Federal Register on December 2.

This rule, effective 60 days from the date of publication, repeals parts of a rule finalized in April 2024 that required nursing homes to provide a Registered Nurse (RN) on site, available to provide services 24-hours per day, 7 days per week and requirements for specific nurse staffing ratios of 3.48 hours per resident, per day of total nurse staffing with at least 2.45 hours per resident, per day of nurse aide staffing and 0.55 hours per resident, per day of RN staffing.

These requirements were successfully challenged by the American Health Care Association and LeadingAge in U.S. District Court for the Northern District of Texas and by a group of LeadingAge state affiliates and state attorneys general in U.S. District Court the for the Northern District of Iowa.

Initially, the Department of Justice appealed these decisions on behalf of the Department of Health and Human Services (HHS); however, after Congress included a 9-year moratorium on the rule in HR 1, the fiscal year 2025 appropriations, the Centers for Medicare & Medicaid Services (CMS) submitted the interim final rule to repeal the staffing standards.

“Today’s interim final rule, which repeals the one-size-fits-all staffing standards … is an important milestone in ongoing efforts to ensure quality care in nursing homes–a goal that LeadingAge and our mission-driven and nonprofit members steadfastly support,” said LeadingAge president and CEO Katie Smith Sloan in a press release.

It is important to note that the rule released on December 2 does not repeal the entire rule that was finalized in May 2024. The interim final rule repeals only the staffing standards portion of this rule. Requirements for enhanced Facility Assessment and Medicaid payment transparency reporting remain in effect. The rule also includes a comment period for soliciting public feedback, which CMS will use to guide future rulemaking.

It is likely that we will see a rule proposed in the future that addresses nursing home staffing in some way.

At this time, nursing homes must continue to meet pre-existing requirements for sufficient nursing staff with the appropriate competencies and skills sets to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.

For more information on the life of this rule, check out the LeadingAge serial post.