The Centers for Medicare & Medicaid Services issued an interim final rule with comment to repeal the final nurse staffing rule, which researchers estimated would save the lives of 13,000 residents each year. Comments on the interim final rule were due February 2, 2026, the same day that the repeal went into effect. There is considerable opposition to repealing nursing home staffing standards.
Eighteen state Attorneys General urged CMS to enact a new staffing regulation “that mandates tailored quantitative minimum staffing requirements, which would prevent Medicare and Medicaid fraud, protect vulnerable long-term care residents, and improve access to care,” while not preempting any higher staffing standards that states enact. The Attorneys General cite the “longstanding and well-documented association between staffing and quality of care in long-term care facilities.” They also express concern that “too many for-profit facility owners and operators across the country have violated qualitatively expressed minimum staffing rules and deliberately operated chronically understaffed facilities to extract profits.” They cite former Skyline Healthcare owner Joseph Schwartz, Philip Esformes, Paul Walczek, Bob Dean, Jr., Kevin Breslin, and Rocky Lemon as defendants in state and federal law enforcement fraud proceedings.
Ninety-three organizations signed a letter opposing the final staffing rule. They cite the importance of staffing to ensuring that residents’ needs are met and contend that “failure to mandate staffing levels has permitted nursing homes to divert funds from creating quality jobs and driven extremely high turnover.”
Senator Ron Wyden and six colleagues introduced the “Nurses Belong in Nursing Homes Act” to put into federal law the requirement of the final staffing rule that nursing homes have 24 hours per day of registered nurse coverage. The bill also requires a new study to develop minimum staffing requirements of no less than 3.48 hours per resident day of nursing care. Permanent funding of survey and certification activities is also mandated. Senator Richard Blumenthal (D-CT), a Senate co-sponsor, said that federal minimum staffing requirements “‘would establish basic minimum standards for how many of these workers are there for each of the patients. To avoid bed sores, falls, or starvation. Or simply lack of quality of life.’”
February 19, 2026 – T. Edelman