When CMS finalized the staffing mandate in April 2024, facilities were told to meet:
- 3.48 hours of nursing care per resident per day
- 0.55 hours from RNs
- 2.45 hours from CNAs
- A 24/7 onsite RN requirement
Providers pushed back hard: not because they opposed staffing — but because the mandate did not match workforce reality. Courts agreed. Twenty state attorneys general agreed. Congress agreed, passing the One Big Beautiful Bill Act, which created a nine-year moratorium on the requirements.
This week, HHS made it official: the staffing mandate is repealed.
CMS acknowledged that the original rule imposed:
- A one-size-fits-all model across vastly different markets
- Unachievable expectations given labor shortages through 2030
- Closure risks for rural and underserved facilities
- Operational instability for providers already stretched thin
The agency reinstated the longstanding requirement:
- An RN onsite for at least 8 consecutive hours, daily
- A full-time RN Director of Nursing (unless waived)
Important: Some Parts of the 2024 Rule Remain in Place
Two components survive:
1. Facility Assessment Modernization (in effect since August 2024)
2. Medicaid Institutional Payment Transparency Reporting
These elements will continue shaping provider accountability and future funding discussions.
What Smart Facilities Should Do Now
The mandate is gone — but the workforce crisis is not.
1. Reevaluate workforce plans, not minimums
2. Strengthen RN coverage and scheduling flexibility
3. Reinforce CNA pipelines
4. Prepare for more scrutiny — not less
5. Shift resources toward retention and training
6. Reassess capital and procurement plans
Industry Leaders: A Win, and a Warning
AHCA’s Clif Porter called this a victory for seniors, families, and providers.
LeadingAge’s Katie Smith-Sloan cautioned that despite the repeal, workforce investment remains critical.
Final Takeaway: The Playing Field Just Reset
CMS didn’t just remove a rule; it shifted power back to providers. The flexibility returned is significant — but it favors the facilities that move fastest.
The organizations that win the next decade will be the ones that use this moment to stabilize their workforce, strengthen operations, invest smartly, and stay focused on resident-centered care.
At SupplyLine, we know that regulatory shifts don’t take away your workload—they reshape it.
As facilities navigate new staffing flexibility, workforce pressures, and budget realignment,
our mission stays the same: support operators with reliable distribution, sharp pricing,
and the operational breathing room you need to focus on care—not chaos.
Whether you’re stabilizing labor, updating equipment, or strengthening procurement strategy,
SupplyLine is here to help you execute fast, stay compliant, and stretch every dollar further.
Nationwide distribution. Thousands of products. No contracts. No complications.
Just a partner who understands long‑term care and delivers—every single time.
Let’s move forward, smarter and stronger.
— The SupplyLine Medical Team