HHS Drops 24/7 RN Requirement for Nursing Homes, Leaves Core Staffing Minimum Intact
The move follows a federal ruling that questioned CMS authority over round-the-clock staffing.
Overview
- CMS issued an interim final rule on Dec. 2 withdrawing the requirement for a registered nurse to be on-site 24 hours a day at long-term care facilities.
- The prior federal baseline of RN coverage for eight hours per day, seven days a week remains in effect.
- The 2024 rule’s minimum staffing standard of 3.48 hours per resident per day remains on the books for now, though it continues to face legal and political challenges.
- HHS said the change aims to protect access in rural and Tribal communities and noted Tribal leaders’ concerns about inadequate consultation during the original rulemaking.
- A Texas federal judge had vacated the 24/7 RN provision earlier this year, industry groups praised the rollback, and analyses cited workforce shortages and costs including CMS estimates up to $6.8 billion and an AHCA estimate of 102,000 additional staff needed.