President Joe Biden wanted nursing homes to boost staffing to provide better care. But in April, a federal judge blocked those staffing requirements, ruling (ironically, in the Trump era) that regulations “must be consistent with Congress’s legislation governing nursing homes.” This summer’s big ugly budget reconciliation bill delayed implementation of the staffing rule for nine years.
This week King Don’s Department of Health and Human Services repealed the Biden rule:
The Department of Health and Human Services today repealed key provisions of the minimum staffing standards for long-term care facilities finalized in 2024.
The move follows months of legal and legislative challenges, which had already rendered hourly staffing and registered nurse requirements moot.
…Notice of the [repeal] was posted in the Federal Register Tuesday morning.
The 2024 staffing rule established a requirement for all nursing homes 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 a registered nurse per resident per day, and 2.45 hours from a nurse aide per resident per day. Providers roundly objected to those rules, saying they did not account for labor challenges or give the flexibility needed to address different resident needs.
The rule had also imposed a requirement that each facility have a registered nurse onsite all day, every day — an element that appeared impossible with the nation facing a chronic RN shortage through at least 2030 [Kimberly Marselas, “Bulletin: HHS Repeals Nursing Home Staffing Rule Provisions,” McKnight’s Long-Term Care News, 2025.12.02].
The folks making money on health care are generally pleased that Uncle Sam won’t make them provide better care:
“The [American Hospital Association] applauds CMS’ repeal of the misguided minimum staffing requirements for long-term care facilities,” said Stacey Hughes, AHA executive vice president for government relations and public policy, in a statement shared with media. “The AHA has repeatedly raised concerns that the requirements could exacerbate workforce shortages, lead to facility closures and jeopardize access to care, especially in rural and underserved communities that often do not have the workforce levels to support these requirements. The AHA appreciates the administration’s recognition that safe staffing of any health care facility has always been about clinical judgment and flexibility to meet continually evolving patient needs rather than meeting arbitrary, one-size-fits-all numbers set by regulation” [American Hospital Association, press release, 2025.12.02].
Counties also fretted that the Biden rule would have exacerbated the nursing shortage and left their aging constituents with fewer services. However, the Trump Administration isn’t doing much to expand that needed workforce. Just a couple weeks ago, the feds removed nursing from the category of “professional degrees” that can access bigger student loans. Kicking immigrants out of the country will deplete the direct care and long-term care workforce, 28% of which is immigrants. Combine that immigration crackdown with cuts to Medicaid, and the harm that the Trump Administration is doing to nursing homes overwhelms the minor relief of suspending the Biden Administration’s well-intended staffing requirements.
It fits, kill off the oldsters quick. It frees up money for the billionaire class who really need it.
The sooner they die the sooner the sooner the cruelty of this maladministration becomes moar clear.
There is a solution if grandma is healthy enough. Attempt to rob a bank or actually do it and then surrender to the police. That way you get to go to the club fed where you will be watched and taken care of. There was a man who did just that in Rapid City some years ago before Obamacare. He robbed a local bank and then allowed himself to be captured in the casino at the Nebraska border. He had some serious health issues and that is how he was able to get them taken care of. So there you go.
This is one of the areas where progressives/Biden admin really screwed up, especially in rural America. In our little town, most of us still have confidence that nursing home residents are relatively well taken care of, because some of us are in and out of the place quite often. As a former legislator I also have been quite aware of the staffing challenges our nursing homes have had. To require a registered nurse to be on duty 24 hours per day was an expense our state’s meager Medicaid reimbursement rate did not and does not cover, to say nothing of the fact that it is an inefficient use of registered nurse resources. In many Midwest communities, we depend on the humanity of the local owners and/or employees rather than regulations to ensure resident safety. I am convinced that regulations like this convinced otherwise sane people to keeping voting for Republicans…along with the encouragement of their literalist preachers, but I digress…