Separately, proposed restrictions on state provider taxes embedded in the same legislation could reduce Medicaid reimbursement rates, creating additional financial pressure on operators already managing workforce shortages and payroll-based journal compliance obligations.
Nursing Home Staffing Mandate Repeal Hits Snag in Senate
A repeal of the nursing home staffing mandate could have been among several provisions in the Republicans’ “One Big, Beautiful Bill” that would have been subject to a 60-vote threshold if it were to remain in the bill by the time the Senate took a vote on it this week. However, the 10-year moratorium on the mandate has been placed back in. Given their narrow majority in the Senate, Republicans are aiming to fast-track the spending bill using the budget reconciliation process, which allows passage by a simple majority but also imposes stricter conditions.
— Skilled Nursing News, June 30, 2025
BREAKING: Senate Parliamentarian Punctures Nursing Homes’ Hopes for Easy Staffing Rule Dismissal
A provision to kill the federal nursing home staff rule could be stripped from a massive 10-year spending reconciliation bill because it is subject to a standing Senate rule that forbids policy changes in such legislation. Nursing homes had been banking on the provision’s inclusion in the bill, which has been the priority of both Congress and the administration so far this year. But the Senate parliamentarian ruled Sunday that “portions of the rule which have gone into effect are subject to the Byrd Rule.”
— McKnight’s Long-Term Care News, June 29, 2025
Health Care Week in Review | Senate HELP Committee Releases Budget Reconciliation Text
On June 11, 2025, the Senate HELP Committee released its portion of the budget reconciliation bill. The HELP Committee text also adopts House language to fund cost-sharing reduction payments.
— JD Supra (Alston & Bird), June 13, 2025
House GOP Budget Proposal Calls for Moratoria on Nursing Home Staffing Mandate, New Provider Taxes
“This section requires HHS to delay implementation, administration, or enforcement of the final rule titled ‘Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting’ until January 1, 2035,” the proposal states. It’s a bit baffling as to why Congress chose to propose a 10-year moratorium, rather than repealing it outright.
— Skilled Nursing News, May 12, 2025
Lawmaker Vows to ‘Make Sure’ Federal Nursing Home Staffing Rule Is Overturned
“You’re all familiar with the nursing staff ratio mandate proposed by the last administration and all the damage it would do to rural nursing homes,” she said. “So I’m going to go forward with the legislation because we need to make sure this rule is overturned.” Fischbach also said she expected the Department of Health and Human Services to appeal the rule within a designated 60-day window.
— McKnight’s Long-Term Care News, April 10, 2025
Nursing Home Staffing Mandate Bill Reintroduced at Critical Juncture
Sens. Deb Fischer (R-NE) and James Lankford (R-OK) have reintroduced a bill to overturn the federal nursing home staffing mandate just as Congress ratchets up its negotiations over staggering cuts to government spending. Senate leaders have targeted Fischer’s bill for inclusion in budget reconciliation efforts, seizing on an estimate from the Congressional Budget Office that found it would cost the federal government $22 billion over a decade.
— McKnight’s Long-Term Care News, February 28, 2025
Senate Bill May Repeal Nursing Home Staffing Mandate, But Steep Medicaid Cuts Likely Would Follow
The split approach, according to Roll Call, would first help pay for enhanced immigration enforcement by axing the nursing home staffing mandate — which was projected to cost the federal government $22 billion over a decade, according to a Congressional Budget Office report last summer. But even if it’s pushed off for now, budget-related pain almost certainly would come later in the form of Medicaid cuts that could cap federal spending for the program or create block grants.
— McKnight’s Long-Term Care News, February 20, 2025
Consumer Groups Urge Congress to Reject Repeal of Nursing Home Staffing Rule in Year-End Dealmaking
Eighteen consumer advocacy groups and employee unions have formally asked congressional leaders to reject any proposed repeal of the new federal nursing home staffing rule as part of its year-end budget wrangling. It’s a colorfully worded reminder for providers that even amid promising lawsuits, the mandate requiring major increases in registered nurse and certified nurse aide hiring maintains popular support in many circles.
— McKnight’s Long-Term Care News, December 12, 2024
