On July 4, 2025, Congress enacted a law placing a moratorium on the implementation and enforcement of the Centers for Medicare & Medicaid Services (CMS) minimum staffing rule for nursing homes. Section 71111 of the One Big Beautiful Bill Act prohibits the Department of Health and Human Services from enforcing the staffing requirements finalized by CMS on May 10, 2024, until September 30, 2034.
The suspended rule mandated 24/7 on-site registered nurse (RN) coverage and a minimum of 3.48 nursing hours per resident day (HPRD), including specific minimums for RNs and nurse aides. These requirements will not be applied or enforced during the moratorium.
Existing federal regulations remain in effect, including the requirement for “sufficient” staffing to meet resident needs and an RN on duty for at least 8 consecutive hours daily. The moratorium does not affect state staffing laws or standards.
Facilities should continue to comply with current federal and state staffing requirements and stay informed of any future regulatory changes.
Compliance Perspective
Issue
The federal moratorium on the CMS minimum staffing rule, effective through September 30, 2034, suspends enforcement of specific quantitative staffing requirements, including the 24/7 Registered Nurse presence and minimum nurse staffing hours per resident day. However, facilities remain responsible for meeting existing federal requirements for sufficient staffing and complying with any applicable state staffing laws. Facilities should continue to assess and adjust staffing levels based on resident needs and ensure that staffing practices support safe, high-quality care.
Discussion Points
- Review and update staffing-related policies and procedures to ensure they align with current federal and state requirements. Confirm that the Facility Assessment, as required by F838, accurately reflects current resident needs and guides appropriate staffing decisions for each shift.
- Provide training to nursing and direct care staff on their responsibilities under existing staffing standards, emphasizing resident-centered care and professional competencies. Ensure appropriate staff understand state staffing regulations. Include education on facility policies, care quality expectations, and how to recognize and report staffing concerns.
- Conduct regular audits to verify staffing levels meet resident needs and staff assignments comply with policies and regulations. Confirm the Facility Assessment is current and reflects resident acuity and census. Use audit results to guide Quality Assurance and Performance Improvement (QAPI) efforts.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*