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.

SNF Minimum Staffing Standard Published: Tell CMS How New Mandate will Impact your SNFs and Access to Care

September 11, 2023

On September 1, the Biden Administration officially published for public comment a proposed rule that would mandate minimum staffing levels at skilled nursing facilities. A 60-day comment period began September 6 and will end with all comments due on November 6.

Lutheran Services in America will be submitting comments sharing our concerns about the proposed new requirement and helping you do the same. We are currently analyzing the full rule and what it means for our network, but our initial concerns include the 24/7 RN requirement, only allowing time-limited hardship exemption waivers, and lack of funding for implementing mandated staffing increases.

Since early 2022 when the Administration originally announced their intent to mandate minimum staffing levels, we have heard from many of you that the uniform application of this new requirement, on top of the enduring workforce shortage in direct care, will result in reduced access to long-term care for older adults in rural and underserved communities as providers continue to struggle to fill staffing vacancies. We have worked diligently to ensure that the concerns of our network are heard and incorporated into the new rule, including meetings with key senators, the White House Domestic Policy Council, and CMS Administrator Chiquita Brooks-LaSure.

Our collective voice is powerful, and we look forward to continuing to bring its impact to bear on this rule.

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

Supporting
Our Neighbors,

TOGETHER.

Our shared Lutheran tradition of service to our neighbor is more vital than ever.

Join us as we work to ensure our network continues delivering essential services to all in need.