HHS’ Cleanup of Federal Nursing Home Minimum Staffing Standards Rule Expands Access to Rural and Tribal Health Care

WASHINGTON – December 2, 2025 – Today, the U.S. Department of Health and Human Services (HHS) repealed provisions of the Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule, originally finalized by the Centers for Medicare & Medicaid Services (CMS).

HHS takes this action after determining the final rule imposed by the Biden Administration disproportionately burdened facilities, especially those serving rural and Tribal communities, and jeopardized patient’s access to care.

Today’s decision to repeal these provisions, in alignment with the One Big Beautiful Bill Act, underscores HHS’s commitment to practical, sustainable approaches to improving nursing home care, and allows for further opportunity for engagement with community and Tribal stakeholders.

“Safe, high-quality care is essential, but rigid, one-size-fits-all mandates fail patients,” said HHS Secretary Robert F. Kennedy, Jr. “This Administration will safeguard access to care by removing federal barriers—not by imposing requirements that limit patient choice.”

“Every American deserves access to compassionate, high-quality care,” said CMS Administrator Dr. Mehmet Oz. “At CMS, our mission is not only to improve outcomes, but to ensure those outcomes are achievable for all communities. We cannot meet that goal by ignoring the daily realities facing rural and underserved populations. This repeal is a step toward smarter, more practical solutions that truly work for the American people.”

The 2024 rule had established a federal requirement that nursing homes participating in Medicare and Medicaid 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, along with requirements that each facility have a registered nurse onsite 24/7. These measures disproportionately burdened rural and underserved communities already grappling with critical health care workforce shortages.

Importantly, Tribal communities expressed concern that they may not have been adequately consulted about the repealed nursing staffing requirements in the original rulemaking process considering the significant impact the rule would have had on long-term care facilities operating in Indian Country. HHS is actively working to ensure that future policymaking includes robust Tribal consultation that upholds Tribal sovereignty.

“The Oneida Nation appreciates Secretary Kennedy for recognizing the unique staffing challenges in tribal communities and rescinding a rule that would have severely limited our ability to care for our elders,” said Chairman Tehassi Hill of the Oneida Nation.

The repeal advances President Trump’s Executive Order, Unleashing Prosperity Through Deregulation, which directs federal agencies to eliminate unnecessary regulatory burdens and return decision-making power to communities and individuals.

HHS remains committed to improving the quality of care in America’s nursing homes while also advancing access for rural and Tribal populations.