Across the United States, nursing homes provide daily care and medical support for seniors who struggle to live independently. This care can only be provided when these facilities are adequately staffed, though. If a nursing home isn’t staffed correctly or consistently, it can create issues of safety, dignity, and quality of life.

Recently, the Centers for Medicare & Medicaid Services (CMS) rescinded the minimum staffing standards that had been adopted in 2024 for nursing homes participating in Medicare and Medicaid. The repeal became officially effective on February 2, 2026, only two months after it was announced. The decision has sparked concern from nursing home safety advocate groups and legal professionals, including our attorneys at Brown & Barron, LLC, because fully staffed facilities are necessary to provide safe resident care.

CMS Federal Minimum Staffing Standards & Rescission

In 2024, CMS finalized a rule establishing federal minimum staffing standards for long-term care facilities. The rule was meant to acknowledge that more staff at a nursing home or long-term care facility inherently reduced the risk of nursing home abuse or neglect.

Under that rule, nursing homes would be required to provide at least:

• 3.48 hours of total nursing care per resident per day, including 0.55 hours from a registered nurse (RN) and 2.45 hours from a nurse aide
• Registered nurse on-site 24 hours a day, seven days a week

However, CMS recently issued an interim final rule rescinding those minimum staffing requirements. Under the new policy, many of the quantitative staffing mandates, including the hourly minimums and 24/7 RN requirement, will no longer apply. Instead, CMS has reverted to older standards that require only eight consecutive hours of RN coverage per day and a full-time RN director of nursing unless a waiver is granted.

CMS has justified its decision by citing workforce shortages, especially in rural and underserved areas, and by pointing to a congressional delay in the enforcement of the 2024 rule. But critics argue that rescinding minimum staffing standards removes protections for residents and fails to address underlying workforce challenges such as retention, wages, and training.

Adequate Staffing Is a Matter of Resident Safety

Nursing home residents often need complex and continuous care. Without adequate staffing, essential needs, like assistance with bathing, toileting, dressing, medication management, and infection monitoring, can go unmet. Studies and expert analysis have repeatedly shown that higher staffing levels are linked to better health outcomes for residents, including fewer falls, reduced hospitalizations, and lower rates of pressure ulcers and preventable complications. While a federal minimum staffing standard does not guarantee perfect care, it establishes a baseline that helps protect residents from chronic understaffing and neglect.

Before CMS’s 2024 rule, there was no uniform federal requirement for minimum staffing hours. That meant staffing levels varied widely among facilities, and homes with fewer staff could still operate without federal consequences. Advocates for strong staffing standards argued that this contributed to inconsistent care quality and avoidable harm to elderly residents.

Removing federal minimums without replacing them with meaningful alternatives could lead some facilities to make staffing decisions based solely on cost rather than patient needs. In an environment where many nursing homes already struggle to hire and retain qualified staff, advocates argue that allowing staffing levels to drop further will only exacerbate the risk of inadequate care.

National Consumer Voice & Other Groups Are Speaking Up

To combat the rescission and protect nursing home residents, advocacy groups like The National Consumer Voice for Quality Long-Term Care have been vocal in condemning CMS’s action. In comments submitted to CMS, Consumer Voice pointed out that the original minimum staffing rule was projected to save thousands of lives annually and significantly improve residents’ quality of care. The organization continues to encourage public engagement, including submitting comments opposing the rescission before the federal comment period closes.

Consumer Voice argues that the staffing challenges nursing homes face are not fundamentally the result of arbitrary numerical requirements, but rather issues of job quality and workforce retention. Addressing compensation, professional support, and training for nursing staff nationwide would help sustain a strong direct-care workforce capable of meeting residents’ needs.

Other national groups, healthcare associations, and consumer advocates have also expressed concern about the rollback, noting that minimum staffing standards, while not perfect, create accountability and help align facility practices with residents’ safety and well-being.

Brown & Barron, LLC Supports Resident Safety

At Brown & Barron, LLC, we represent clients and families affected by nursing home neglect and abuse. We know how devastating inadequate staffing can be, and when residents are left waiting for help, when personal needs go unmet, and when opportunities to prevent harm are missed simply because there weren’t enough hands on deck.

Strong staffing standards help residents receive timely medical attention, personalized care, and responsive support. Rolling back these protections risks returning to a patchwork of staffing practices where some nursing homes prioritize cost savings over resident health and safety. The decision by CMS to rescind minimum staffing standards in nursing homes represents a significant shift in federal policy. While facility staffing decisions are complex and workforce challenges are real, removing baseline protections threatens the quality of care for some of society’s most vulnerable adults.

We proudly stand with advocacy organizations calling for federal policy that promotes, not weakens, safe staffing levels in long-term care. Every resident deserves dignity, respect, and competent care, and our laws and regulations should reflect that priority.

If you or a loved one has experienced neglect or abuse in a nursing home in Maryland, our lawyers can help. Contact us online or call (410) 698-1717 to discuss your case and learn more about your legal options.