Maryland Nursing Home Lawyer Blog

Last updated July 13, 2026 · Reviewed by the attorneys at Lebowitz & Mzhen

Staffing is the single factor that most determines whether a nursing home resident is safe, and the federal rules on it just got weaker. As the law firm Duane Morris reported in a client alert, the Centers for Medicare and Medicaid Services issued an interim rule rescinding the minimum staffing standards for long-term care facilities that had been finalized in 2024, with the change taking effect February 2, 2026. Those standards would have set a floor on direct-care hours per resident and required around-the-clock registered nurse coverage. With them gone, facilities return to a lighter federal requirement. For Maryland families with a loved one in long-term care, it is worth understanding what this does and does not mean.

What the Repeal Changes, and What It Does Not

Families place a loved one in a nursing home trusting that enough trained people will be there to provide care around the clock. A recent change in federal policy makes that trust harder to verify. An interim rule from the Centers for Medicare and Medicaid Services took effect on February 2, 2026, repealing the federal minimum staffing standards for nursing homes, including the requirement that a registered nurse be on site 24 hours a day. The rule rolls facilities back to an older baseline that generally calls for a nurse on site only part of the day.

How Thin Staffing Turns Into Resident Harm

Most nursing home injuries trace back to a shortage of hands rather than a single dramatic act of cruelty. When a facility runs short of nurses and aides, residents wait longer for help, and the consequences show up on their bodies. A resident who is not turned regularly develops pressure wounds. One who is not helped to the bathroom in time falls trying to get there alone. Medications get delayed or missed, infections go unnoticed until they turn serious, and residents who need supervision wander away from the building. The connection between staffing and safety is direct, and loosening the rules removes a floor that families could once count on.

What Maryland Families Should Ask and Watch For

With the federal floor gone, the job of confirming adequate staffing shifts onto families choosing a facility and onto those already visiting a loved one. It helps to ask pointed questions before a placement and to stay alert afterward. Signs that staffing may be falling short include:

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On December 3, 2025, the Centers for Medicare and Medicaid Services published an interim final rule rescinding key provisions of the 2024 federal minimum staffing standards for long-term care facilities. Effective February 2, 2026, the rule that would have required nursing homes nationwide to maintain a registered nurse on site 24 hours a day, seven days a week, and to meet minimum hours-per-resident-day staffing levels (3.48 total, 0.55 for RNs, 2.45 for nurse aides), was withdrawn.

The rescission cited three drivers: a congressional moratorium under Public Law 119-21 that prohibited enforcement until at least September 30, 2034, two federal district court decisions (in the Northern District of Texas and the Northern District of Iowa) that vacated parts of the rule, and CMS’s own determination that the rule was no longer appropriate as a matter of policy.

Resident advocates condemned the change. The National Consumer Voice for Quality Long-Term Care, which had estimated the staffing rule could save 13,000 lives a year, called the repeal a serious setback. Senate Finance Committee leadership warned that residents would be less safe.