CMS Repeal of Nursing Home Staffing Rules

The Nursing Home Abuse Center is providing context for residents and families following a federal policy shift that rescinds minimum staffing requirements for Medicare- and Medicaid-certified nursing homes, including the requirement that a registered nurse be on-site 24 hours a day.

In early December 2025, the Centers for Medicare & Medicaid Services (CMS) issued an interim rule to repeal the federal minimum staffing standards for long-term care facilities, with an effective date of February 2, 2026.

The repeal rolls back elements that would have established nationwide staffing expectations, including around-the-clock registered nursing coverage. It also restores facilities to prior federal requirements that generally require a nurse to be on site for at least eight consecutive hours per day.

The Debate Behind Nursing Home Staff Regulations

Advocates and industry groups have long debated whether staffing should be regulated through national minimums or addressed through a combination of existing oversight, state rules, and facility-level performance measures.

Supporters of minimum staffing levels have argued that having enough staff is closely tied to resident safety and can help prevent nursing home abuse. High turnover, low wages, and other factors mean that many facilities are chronically understaffed, which could impact the quality of care provided to residents.

Opponents have said rigid requirements can be hard to meet in areas facing persistent workforce shortages.

“Policy changes can be confusing for families who are trying to understand what level of care their loved one will receive. Our goal is to explain what this repeal does and does not change, and to help families make a more informed decisions.”

– Julie Rivers, Nursing Home Abuse Center spokesperson

How Will the CMS Repeal Impact Nursing Home Care?

Independent observers say the impact of the CMS ruling may vary widely by facility and state. Some nursing homes will continue to provide high-quality care, while others may struggle.

“Even without a federal minimum, staffing levels remain a key quality indicator, and oversight doesn’t disappear,” said Elena Martin, a long-term care policy analyst who studies resident safety and workforce conditions.

“The challenge is that families often need clearer information, as staffing adequacy can look very different depending on the facility’s resources, management, and local labor market,” Martin continued.

Signs of Nursing Home Understaffing to Watch for

The Nursing Home Abuse Center notes that regardless of how staffing is regulated, families should note a facility’s overall rating, investigate concerns, and ask about general staff levels before a resident moves in.

These proactive steps can go a long way to keeping loved ones secure and protect them from nursing home abuse.

After moving into a long-term care facility, the Nursing Home Abuse Center also recommends keeping a lookout for common signs of understaffing.

These include:

Bedsores
Medication errors
Unexpected declines in hygiene

Promptly addressing any health concerns that appear in residents is key to keeping them safe, regardless of the underlying cause.

Protecting Nursing Home Residents

It’s important to note that CMS repeal does not eliminate other federal obligations tied to resident rights, quality of care, and safety.

Facilities remain subject to inspections, complaint investigations, and reforms when deficiencies are found. All nursing home residents deserve safe environments to live out their golden years.

The Nursing Home Abuse Center is publishing plain-language information about what the CMS repeal means, what questions families can ask during facility tours, and what steps may be available when a resident’s care needs are not being met.

Call (855) 264-6310 or contact us now to get assistance if you or a loved one may have suffered abuse in a nursing home.