Have you ever visited your loved one at a nursing home and wondered if there’s enough staff there to help them with basic needs — getting out of bed, eating, or managing medications?
Until recently, a federal rule finalized in 2024 aimed to create consistent minimum staffing levels across Medicare- and Medicaid-certified nursing homes nationwide. This rule required nursing homes to staff a minimum number of nursing hours per resident and have a registered nurse (RN) available 24 hours a day, 7 days a week.
However, in December 2025, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) published a new interim final rule that repeals the minimum staffing requirements created in the 2024 regulation.
For families in Kentucky and across the U.S., this change can leave many questions:
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Does this make nursing homes safer or less safe?
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What standards now apply?
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How can I protect my loved one if staffing issues arise?
A Kentucky nursing home abuse lawyer can help you understand your rights and options. At Gray & White, our Louisville nursing home abuse attorneys have a strong track record of advocating for families affected by neglect and abuse. We understand the sensitive and deeply personal nature of these cases and are committed to protecting your loved one’s rights with the care and respect they deserve.
Federal Nursing Home Staffing Regulations Changed in December 2025
Under the 2024 rule — now repealed — nursing homes that participated in Medicare and Medicaid had to:
- Provide at least 3.48 total nursing hours per resident per day, including 0.55 hours of care by a registered nurse and 2.45 hours of care by a nurse aide.
- Have an RN on-site 24 hours a day, 7 days a week
These regulations were scheduled to take effect in 2026 for facilities in urban areas and in 2027 for facilities in rural areas.
The December 2025 interim final rule removes these federal staffing minimums, restoring the previous framework that does not mandate specific numerical staffing levels but still requires facilities to provide sufficient nursing staff to meet residents’ needs. The rule repeals the 24/7 RN requirement and the specific hours-per-resident mandates, while maintaining the requirement that nursing homes use RNs for at least eight consecutive hours per day and have a full-time director of nursing.
What Nursing Home Regulations Changes Mean for Your Loved One’s Nursing Home Facility
Nursing home regulations establish the minimum staffing requirements for nursing homes that accept Medicare and Medicaid. Without specific hours, nursing homes may decide staffing levels based on internal policies or business models. However, nursing homes must still comply with federal regulations requiring sufficient staffing based on resident needs.
Families may need to rely more heavily on facility reporting and oversight tools, such as the Medicare Care Compare website, to assess staffing data. This can make it more challenging to ensure consistent levels of care, especially in facilities already struggling to hire sufficient nurses and aides.
Signs of Understaffing You Should Watch For at Your Loved One’s Nursing Home
Understaffing isn’t always obvious at first glance, but some signs of insufficient nursing home staffing may include:
- Delayed responses to call lights
- Frequently missed personal care tasks
- Unexplained weight loss or dehydration
- More bedsores or falls than expected
- Frequent staff turnover
Sufficient nursing home staffing is not just an issue for lawmakers and business executives. It may be a safety issue for your parent, spouse, or loved one.
The Law Still Protects Nursing Home Residents From Understaffing Dangers
Even without federal regulations that create minimum hours of nursing care, residents are still protected by laws that:
- Guarantee the right to safe and adequate care under Medicare and Medicaid participation rules
- Hold facilities accountable for neglect or abuse if staffing shortages contribute to harm
- Allow families to file complaints with state agencies or pursue legal action when neglect or abuse occurs
A qualified Kentucky nursing home abuse lawyer can help you understand whether staffing levels or care quality put your loved one at risk and advise on steps to protect their rights if they’ve been hurt.
The landscape of nursing home staffing rules is still evolving, and federal or state regulators may introduce new standards in future years. In the meantime, families must stay vigilant about care quality and use all available tools and legal protections to ensure their loved ones receive the attention and respect they deserve.