Over the course of 18 months, SNF leaders watched the federal 3.48 HPPD requirement go from finalized rule (May 2024), to postponed until 2034 (July 2025), to fully repealed (December 2025). If you’re an HR Director or Finance Officer at a skilled nursing facility, you’ve likely experienced whiplash. The question now is: What should you actually plan for when it comes to staffing and scheduling requirements?
What Just Happened?
In December 2025, the Centers for Medicare & Medicaid Services (CMS) rescinded the nursing home staffing requirements that were set to take full effect in 2026 and 2027. The repeal went into effect on February 2, 2026.
The original rule from April 2024 would have required nursing homes to provide 3.48 hours per resident day (HPRD) of total nursing care. This included at least 0.55 HPRD from registered nurses and 2.45 HPRD from nurse aides. It also required a registered nurse to be onsite 24 hours a day, 7 days a week.
Data sets show that only about 19% of nursing facilities currently met all three staffing minimums before the rule was rescinded.
Why the Change?
Congress passed legislation in July 2025 that blocked CMS from enforcing the minimum staffing standards until September 30, 2034. This was part of Public Law 119-21, as noted in the Federal Register.
Additionally, two federal court cases found parts of the rule invalid. CMS decided to remove the requirements entirely rather than keep them on the books without enforcement.
What This Means for Your Facility
Even though the federal HPPD requirements are postponed, this doesn’t mean you should ignore staffing levels. Quality care still requires adequate staffing. Importantly, the enhanced facility assessment requirement remains in effect, which requires facilities to staff based on the actual needs of their residents. Here’s what skilled nursing leaders need to focus on now:
Your State May Still Have Requirements
Some states have their own staffing requirements that remain in place. For example, California requires facilities to provide a minimum of 3.5 hours of direct care per patient day. Check with your state health department or state long-term care association to understand what applies to your facility.
The 5-Star Rating Still Matters
The CMS 5-Star Quality Rating system still considers staffing levels. Facilities with better staffing often receive higher ratings, which affects your reputation and ability to attract residents.
Focus on Retention and Scheduling Efficiency
Without federal mandates, you have more flexibility. But you still need smart scheduling practices to keep your staff happy and reduce turnover. Poor scheduling practices contribute significantly to why caregivers leave their positions, including lack of work-life balance and inadequate schedule control.
Best Practices for 2026 Scheduling
Here are practical steps you can take to improve your scheduling:
- Empower Staff with More Flexibility
Research shows that employees who have flexible work options are significantly more likely to remain with their employer. A top reason caregivers leave their company is a lack of schedule control. Empower your nursing staff by making it easy for them to pick up available shifts and request PTO, giving them autonomy while maintaining operational needs. Just make sure you have clear rules about minimum coverage and maximum hours.
- Use Technology Wisely
Modern scheduling solutions can save care teams significant time, especially when part of an all-in-one workforce management platform. The right software can help you: track certifications and skills, prevent scheduling conflicts, monitor overtime, fill open shifts quickly, and generate compliance reports.
- Post Schedules in Advance
Give staff as much advance notice as possible. This reduces last-minute call-offs and helps employees balance work and personal life. - Monitor Workload Fairly
Keep an eye on overtime and make sure shifts are distributed fairly. The CDC recommends using self-scheduling with guidelines to prevent risky scheduling patterns that lead to fatigue. - Consider Your Staff Mix
Even without federal requirements, you still need the right mix of RNs, LPNs, and CNAs. Match skills to resident needs on each shift.
The Bottom Line
The current federal HPPD landscape seems to offer more flexibility. But don’t see this as permission to cut corners on staffing.
Quality care requires adequate staff. Happy, well-rested employees provide better care and stay with you longer. Poor scheduling leads to burnout, turnover, and ultimately lower quality care.
Focus on scheduling practices that: give staff more control and flexibility, use technology to reduce administrative burden, distribute workload fairly, match skills to resident needs, and keep you compliant with any state requirements.
The skilled nursing workforce shortage isn’t going away anytime soon. The facilities that succeed in 2026 will be those that treat scheduling as a strategic priority, not just an administrative task.
By implementing smart scheduling practices now, you’ll be better positioned to attract and retain quality staff regardless of what federal regulations may come in the future. Empeon’s workforce management solutions help skilled nursing facilities streamline scheduling, reduce administrative burden, and maintain compliance with ease. Our platform gives your staff the flexibility they want while giving you the visibility and control you need.
Ready to transform your scheduling from a headache into a competitive advantage?
Book a demo today to see how Empeon can help you build a more efficient, sustainable staffing strategy for 2026 and beyond.
