Staffing Mandate Legal Battle: Administration Withdraws Eighth Circuit Appeal

The Department of Justice has voluntarily dismissed its appeal of a federal district court ruling that vacated the Biden administration’s nursing home minimum staffing mandate, effectively clearing the path for the regulation’s demise. The dismissal, filed in the U.S. Court of Appeals for the Eighth Circuit on October 24, signals that the current administration does not intend to defend the rule that would have required 3.48 nursing hours per resident day at all Medicare- and Medicaid-certified nursing homes.

Legal Background

The Northern District of Iowa ruled in June 2025 that CMS exceeded its statutory authority in establishing numeric staffing minimums, finding that Congress had not granted the agency power to set specific staffing ratios. The court also found the rule’s cost-benefit analysis inadequate and the implementation timeline arbitrary.

The Biden administration’s DOJ initially filed a notice of appeal and submitted preliminary briefs defending the rule. However, following the change in administration, DOJ filed a motion for voluntary dismissal, citing the new administration’s policy review.

Regulatory Implications

With the appeal dismissed and Congress having separately prohibited CMS enforcement through 2034, the staffing mandate is effectively defunct. Industry observers expect CMS to formally rescind the rule through notice-and-comment rulemaking in the coming weeks, providing regulatory clarity for facilities that had been preparing for potential compliance.

The voluntary dismissal does not create binding appellate precedent, leaving the legal question of CMS’s authority to set staffing ratios unresolved for potential future administrations.

State-Level Landscape

With federal requirements off the table, state staffing regulations remain the binding standard. Currently, 37 states have some form of nursing home staffing requirement, though standards vary widely from general “sufficient staffing” language to specific numeric ratios. Several states have considered strengthening their requirements in the absence of federal action.