In 2024, the U.S. Department of Health and Human Services (“HHS”) promulgated the "Minimum Staffing Standards for Long Term Care Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule" ("2024 Rule"). This regulation imposed what many believed to be burdensome and impracticable staffing requirements on long-term care ("LTC") facilities.
On December 2, 2025, HHS repealed the 2024 Rule as numerous LTC providers opposed the 2024 Rule because of concerns about the ability of providers to pay for required staffing levels and the challenges involved in finding the employees needed to fulfill the obligations, especially in rural and underserved communities.
The new rule (“New Rule”), which went into effect on February 2, 2026, removed the 2024 Rule's requirement that skilled nursing facilities (“SNFs”) have 24/7 onsite RN services. The New Rule requires SNFs to have an RN for at least eight consecutive hours a day, seven days a week, and to designate an RN to serve as the Director of Nursing on a full-time basis, except when waived.
The 2024 Rule required SNFs participating in Medicare and Medicaid to provide residents with a minimum total of 3.48 hours of nursing care per day, including at least 0.55 hours from an RN per resident per day, and 2.45 hours from a nurse’s aide per resident per day. Those mandates are no longer in effect.
In addition, there is now a 10-year moratorium on re-implementing the minimum staffing requirements in the 2024 Rule, effectively freezing any effort by HHS to re-impose the 2024 Rule for the next decade.
If you would like to discuss this recent development or have questions regarding other LTC regulations, please contact Ferrier Stillman at Tydings.