AARP Backs Bill to Restore Slashed Staffing Standards in Nursing Homes

AARP is pushing lawmakers to reinstate regulations that would require more nurses and aides in nursing homes funded through Medicare and Medicaid

Molly Snow,

Updated March 12, 2026

AARP

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Published December 10, 2025

/ Updated March 12, 2026

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Smiling nurse holding hand of senior man walking with rollator in corridor at retirement home

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The Trump administration rolled back federal minimum staffing requirements for nursing homes, which advocates say are key to resident safety and easing chronic understaffing as facilities continue to recover from the pandemic.

But a group of lawmakers are seeking to restore the rules, and AARP is backing the effort to ensure nursing home residents retain access to quality care, especially as Medicare funding cuts are expected to further hamstring providers.

The Nurses Belong in Nursing Homes Act, introduced in the Senate on Feb. 12, requires a registered nurse to be on site at all times and strengthens minimum direct care staffing requirements for nursing facilities.

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“Unfortunately, many nursing homes still lack around-the-clock registered nurse coverage and operate with overall staffing levels that fall short of residents’ needs,” wrote Bill Sweeney, AARP’s senior vice president of government affairs in a March 9 letter endorsing the bill.

The bill also stipulates that nursing homes provide at least 3.48 hours of direct care per resident per day. Of that, about half an hour must come from a registered nurse and roughly two and a half hours from a nurse’s aide.

In 2025, many nursing homes — nearly two-thirds — were already meeting or exceeding hourly care requirements.

In addition, the bill calls for federal fines levied on nursing homes due to noncompliance with regulations to be used to recruit, retain and repay loans for nurses who commit to staying in the field.

Standards repealed in December

On Dec. 2, the U.S. Department of Health and Human Services (HHS) announced an interim final rule rescinding the nursing home staffing requirements. The rules were originally slated to take effect in 2029.

AARP opposed the move, saying it permits facilities to take in residents they don’t have the resources to care for. Medicare- and Medicaid-funded nursing homes provide long-term care for nearly 1.2 million people nationwide.

“Rolling back these standards would weaken accountability, undermine program integrity and allow facilities to continue receiving billions in taxpayer dollars without demonstrating that they have enough staff to care for the residents they are paid to serve,” wrote Megan O’Reilly, AARP’s vice president of government affairs, in a Feb. 2 letter to Dr. Mehmet Oz, who leads the Centers for Medicare & Medicaid Services.

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But federal officials said they determined the rules, adopted under President Joe Biden’s administration, were too costly and disproportionately burdened facilities serving rural and tribal communities that already struggle to recruit and retain health care workers.

A 2024 analysis by KFF found that rural nursing homes would be as likely as urban ones to meet the final rule’s staffing standards, but under the original plan they’d have more time to comply with the requirements.

Congress first delayed implementation until 2034 through the One Big Beautiful Bill Act, signed on July 4, and then suspended these provisions indefinitely in February. However, it left intact other aspects of the rules related to facility assessments and Medicaid payment transparency.

AARP urged protections for residents, staff

Alongside other patient advocacy groups, AARP championed these staffing baselines, citing studies and academic research that link higher quality of care in nursing homes with more staff and fewer adverse outcomes.

The original staffing standards were born from broader efforts in 2022 to improve the safety and quality of service in America’s 15,000 nursing homes after the COVID-19 pandemic illuminated severe understaffing, burnout among frontline workers and slipping standards that resulted in harm to residents.

One estimate by University of Pennsylvania researchers found the staffing rules would save about 13,000 lives each year.

“Every nursing home should be required to meet these bare minimum standards needed to provide safe, dignified care,” wrote Sweeney in a May letter to House lawmakers.

In addition, nursing homes were directed to improve their facility assessments to better reflect patients’ needs and staffing plans for more health care workers.

The rules also upped reporting requirements for nursing homes to publicly disclose Medicaid spending on pay for direct care workers (nursing or therapy staff) and support staff (drivers or maintenance personnel).

Nursing homes will still need to meet the facility assessment requirements, as well as the Medicaid spending disclosures.

While workforce shortages and their impacts on underserved communities are legitimate challenges, the staffing rule bakes in generous exemptions, hardship waivers and extended phase-in timelines, particularly for rural facilities, O’Reilly wrote.

The policy shift also comes at a time when more and more Americans serve as caregivers, while aging population in the U.S. threatens an already overburdened health care system that struggles to keep up with the needs of older households.

For more information on how nursing facilities compare, check out AARP’s Nursing Home Quality and Safety Dashboard.

And if you’re concerned about a loved one’s care, your state’s long-term care ombudsman may be able to help. Find more information here.

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Molly Snow is a writer for AARP covering advocacy issues and state news. She also writes AARP's Today's Tips podcast. She previously worked at other news outlets, including Federal Times, McClatchy and Gannett.