Federal Judge Blocks Nursing Home Staffing Rules, Sparking Fears of Harm from Understaffing

On April 7, 2025, a federal court decision struck down new rules aimed at improving staffing in nursing homes, raising serious concerns for families with loved ones in long-term care facilities.

The rule, finalized in May 2024, required all nursing homes accepting Medicare and Medicaid to:

1. A registered nurse (RN) be onsite 24/7.
2. Minimum daily staffing ratios:
   • 0.55 RN hours per resident
   • 2.45 nurse aide hours per resident
   • A combined total of 3.48 hours of care per resident

These regulations were intended to address chronic under-staffing and improve care quality in long-term care settings.

The lawsuit, brought by the American Health Care Association and joined by the state of Texas, argued that the staffing mandates exceeded CMS’s statutory authority. The court agreed, finding that:

• The 24/7 RN requirement directly conflicts with federal law, which explicitly requires only 8 consecutive hours of RN coverage per day, 7 days a week.
• The fixed hourly staffing ratios violated congressional intent, which called for staffing levels based on the specific nursing needs of a facility’s residents, not blanket numerical standards.
• CMS effectively rewrote the law rather than filling in regulatory details, thereby overstepping its role and infringing on the legislative authority of Congress.

These staffing standards were created to address widespread issues of neglect, understaffing, and poor-quality care in nursing homes across the country. Unfortunately, the court found that the Centers for Medicare & Medicaid Services (CMS) overstepped its legal authority by implementing these requirements, arguing that only Congress can mandate such changes.

Although the court’s decision has paused the implementation of the staffing requirements for now, the larger discussion around quality and accountability in nursing homes continues to evolve.

Why This Matters to You

As a Philadelphia nursing home abuse lawyer, I’ve seen firsthand how inadequate staffing leads to serious, preventable harm. When facilities are short-staffed, residents suffer—bedsores go untreated, falls happen more frequently, infections spread, and medical needs are missed or ignored.

This ruling puts even more pressure on families to stay vigilant. Without strong federal requirements in place, some nursing homes may cut corners—putting your loved one’s safety and dignity at risk.

What You Can Do

• Check staffing levels regularly by asking facility administrators direct questions about nurse-to-resident ratios.
• Visit often and observe closely for signs of neglect, such as weight loss, unexplained injuries, emotional withdrawal, or poor hygiene.
• Report concerns immediately to the Pennsylvania Department of Health or an experienced attorney.

Contact a Philadelphia Nursing Home Abuse Lawyer – We’re Here to Help

If you believe your loved one has been harmed due to understaffing or neglect, you are not alone—and you have legal options. As a Philadelphia nursing home neglect lawyer, I help families hold negligent facilities accountable and fight for the justice their loved ones deserve.

Our team will investigate what happened, explain your rights, and take swift action to protect your family member and others at risk.