A study published on March 3, 2026 in the journal Health Affairs that analyzed longitudinal data from the period 2010–23 on 6,849 nursing homes operating across twenty-two U.S. states estimated the effects of state minimum staffing mandates on staffing levels, financial health, and closures. The study’s authors reported: “Staffing mandates increased total direct care staff by 0.18 hours per resident day, or roughly 5 percent, on average, driven by increases in licensed practical nurses (0.06 hours per resident day) and certified nursing assistants (0.13 hours per resident day). Facilities’ annual labor expenses rose by about $273,000, but these costs were offset by higher net patient revenues (approximately $546,000), leaving net margins unchanged. Mandates did not increase the likelihood of facility closure. Overall, our findings indicate that minimum staffing mandates can meaningfully raise staffing levels without undermining the financial viability of nursing homes.”
The study’s lead author stated: “The financial doom that the industry predicted just didn’t materialize. The data show that these mandates don’t harm nursing homes, and they do help residents.”
Background
In 2024, the Biden administration finalized a federal minimum staffing rule that required nursing homes to have a registered nurse on staff 24 hours per day, 7 days per week, and established a base of 3.48 total hours of direct care per resident per day (at least 3.48 3 hours per resident day of nursing care provided by a combination of a registered professional nurse, licensed practical nurse (or licensed vocational nurse), or certified nursing assistant), which resulted in the nursing home industry filing a lawsuit to stop the minimum staffing requirements. The United States Congress delayed the implementation of the minimum staffing requirements in 2025, followed by the Trump administration rescinding the rule on February 2, 2026, before it could take effect.
In 2025, many nursing homes (almost two-thirds) were already meeting or exceeding minimum hourly care requirements. One estimate by University of Pennsylvania researchers found the staffing rules would save about 13,000 lives each year.
Federal regulations require covered nursing homes to have “sufficient” staff, and each nursing home also provides data to Medicare, which evaluates various factors like turnover and the needs of residents, to score a facility based on staffing.
If you or a loved one may have been injured (or worse) in a nursing home in the United States due to nursing home understaffing, nursing home staff shortage, nursing home infection, nursing home pressure ulcer (nursing home bedsore), nursing home fall, nursing home aspiration, nursing home neglect, nursing home negligence, nursing home abuse, or the nursing home failing to properly care for a vulnerable adult, you should promptly find a nursing home malpractice lawyer in your state who may investigate your nursing home injury claim for you and represent you or your loved one in a nursing home case, if appropriate.
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