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Court Strikes Down Minimum Staffing Mandate, 24/7 Nurse Requirement

April 21, 2025

On April 7, a federal judge in Texas knocked down the Biden Administration’s April 2024 Centers for Medicare & Medicaid Services rule that mandated minimum staffing levels at skilled nursing facilities. In making his decision in favor of plaintiffs challenging the mandate, Judge Matthew J. Kacsmaryk ruled that CMS exceeded their authority and that their regulatory action was not consistent with Congress’s legislation governing nursing homes.

The rule would have mandated that all nursing homes that receive Medicare and Medicaid funding provide a total of at least 3.48 hours of nursing care per resident per day. In addition, nursing homes would have had to have a registered nurse onsite at all times.

Lutheran Services in America has long advocated against these mandates, given the significant negative impact they would have had on access to care, especially in rural areas. We will continue to raise our unified, faith-based voice to ask Congress to permanently block the staffing mandate through legislation.

Sarah Dobson is Senior Director of Advocacy and Public Policy at Lutheran Services in America.

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