Update (November 2026): CMS repealed these federal staffing minimums effective February 2, 2026.
This explains the final rule that came out in April. This is not all that advocates want or think is enough help. However, it is more than has been done in a long time. It’s a start! They will have three to five years to implement these rules, but at least advocates are getting somewhere. Some major highlights is that they will have to have a nurse 24/7 RN onsite, where now it is only 8 hours and we all know that is usually during the day, most times no RN overnight. The minimum staffing hours are still low, but at least we have that now. They will also have to show more transparency in what they do with Medicaid dollars in relation to staff pay.