A federal judge in Texas has stopped a new rule that would’ve required all nursing homes in the U.S. to follow minimum staffing levels—including having a registered nurse on duty 24/7. This would have been the first nationwide rule of its kind, aiming to improve care in facilities often stretched thin.
But the judge said the federal government overstepped its authority with the rule.
What the Rule Was Supposed to Do
The regulation, proposed by the Centers for Medicare and Medicaid Services (CMS), would have required:
- A registered nurse (RN) on-site 24 hours a day
- At least 33 minutes of RN care per resident, per day
It was set to roll out starting in 2026, with more time given to rural facilities that already struggle with staffing.
Supporters—like patient advocates and labor groups—said the rule would improve safety and quality of care. But many nursing home operators warned they simply don’t have the staff to meet these new demands, especially amid a national healthcare worker shortage.
Why the Judge Said No
U.S. District Judge Matthew Kacsmaryk ruled that, while the rule had good intentions, it went beyond the legal powers granted to CMS.
He agreed that staffing and oversight are important—but said this kind of mandate needs to come from Congress, not just a federal agency.
Industry Reaction: Relief and Concern
Clif Porter, CEO of a major nursing home association, welcomed the decision.
“This unrealistic staffing mandate threatened to close nursing homes and displace vulnerable seniors,” he said.
He added that the ruling helps protect access to care for older adults.
Others, especially advocates for seniors, may be disappointed. They believe stronger staffing rules are necessary to prevent neglect and ensure dignity in long-term care.
What Happens Next?
As of now:
- CMS hasn’t responded to the ruling publicly.
- No appeal has been announced.
- Nursing homes will continue under current staffing laws, which vary by state.
This decision is part of a larger national debate about how much authority federal agencies should have—and how we balance quality care with the reality of workforce shortages.