A federal rule aimed at improving patient outcomes in nursing homes in the wake of the Covid-19 pandemic will no longer be enforced, with health authorities saying it unduly burdened rural and tribal communities. 

The U.S. Department of Health and Human Services repealed provisions of the rule, which was initially implemented by the Centers for Medicare and Medicaid Services under the Biden administration. 

“Safe, high-quality care is essential, but rigid, one-size-fits-all mandates fail patients,” said HHS Secretary Robert F. Kennedy Jr. in a statement. “This administration will safeguard access to care by removing federal barriers – not by imposing requirements that limit patient choice.” 

The rule, established in 2024, required nursing homes participating in Medicare and Medicaid provide residents with a minimum total of 3.48 hours of nursing care per day, including 0.55 hours from a registered nurse per resident per day, and 2.45 hours from a nurse aide per resident per day, along with having a registered nurse onsite 24/7. 

More than 1 million Americans receive care in assisted living facilities or nursing homes.  

At the time it was implemented, fewer than one in five facilities met the minimum standard, according to KFF, a health policy research firm.  

However, KFF also reported that rural nursing homes were as likely as urban facilities to meet the final rule’s requirements based on current staffing levels, though rural facilities had more time to comply with them. 

The rule faced stiff opposition from the nursing home industry but was criticized by patient care and family advocates, who said it didn’t go far enough to address how inadequate staffing levels contributed to high mortality rates in nursing homes during the Covid-19 pandemic.