Why RFK Jr.’s Health Department repealed rule for 24/7 nurses in nursing homes

In late 2025, a rumor spread that Robert F. Kennedy Jr., secretary of the U.S. Department of Health and Human Services (HHS), repealed a rule that required registered nurses to be present 24 hours a day, seven days a week, at nursing homes. The change was supposedly set to take effect on Feb. 2, 2026. 

For example, a video on Facebook claimed Kennedy’s decision to end the requirement for registered nurses present at all times in nursing homes could result in poorer health and more deaths among residents of such homes (archived):

“Because of RFK Jr, nursing homes in 2026 won’t be required to have a registered nurse on site around the clock,” the text on the video read. The caption said:

Beginning Feb. 2, 2026, the federal requirement that nursing homes maintain a registered nurse on-site around the clock will no longer exist. Decades of  research has shown what happens when RN staffing decreases: higher infections, more falls, more emergency transfers, higher mortality.

A Dec. 26, 2025, post on Facebook also said Kennedy had repealed the rule for registered nurses at nursing homes (archived). In addition, Snopes readers reached out via email inquiring about the veracity of the claim. 

It was true that HHS announced it would repeal the rule for minimum staffing requirements at long-term care facilities — specifically, the requirement that a registered nurse (RN) be present at all times. (Long-term care facilities include skilled nursing homes.) This decision required context, as the rule HHS repealed met several legal hurdles since the administration of former President Joe Biden, a Democrat, approved it in 2024. Additionally, the 24/7 rule was not set to be effective until May 2026 at earliest, meaning it was not yet in force when HHS repealed it.

History of rules on staffing standards in long-term care facilities

In May 2024, with less than one year left in Biden’s presidency, HHS and Centers for Medicare and Medicaid Services (CMS) announced in the Federal Register (the official journal for the federal government that compiles all agency rules) they would implement a so-called “final rule” that, among other things, required long-term care facilities to keep a registered nurse on site 24 hours a day and seven days a week:

We are revising § 483.35(b) to require an RN to be on site 24 hours per day and 7 days per week (24/7 RN) to provide skilled nursing care to all residents in accordance with resident care plans, with an exemption from 8 hours per day of the onsite RN requirement under certain circumstances.

(A final rule “is a federal administrative regulation that advanced through the proposed rule and public comment stages of the rulemaking process and is published in the Federal Register with a scheduled effective date,” according to Ballotpedia, a website that describes itself as “the digital encyclopedia of American politics.”)

This specific rule was set to take effect in May 2026 for non-rural areas and May 2027 for rural areas. 

The rule soon ran into legal challenges. First, a federal judge in Texas — Matthew Kacsmaryk, whom President Donald Trump appointed during his first administration in 2019 — vacated the minimum staffing requirements of the Biden-era rule in April 2025.

Then, in June 2025, another federal judge, Leonard T. Strand — nominated by former Democratic President Barack Obama in Iowa in 2015 — blocked the standard staffing requirements portion of this rule in a separate lawsuit.  

The law changed

In July 2025, the so-called One Big Beautiful Bill Act included a “moratorium” on staffing requirements for long-term care facilities until Sept. 30, 2034. In other words, the law suspended the rule before it could go into effect. Snopes found the text under the header “Preventing Wasteful Spending” (emphasis ours): 

Subchapter B—Preventing Wasteful Spending

SEC. 71111. MORATORIUM ON IMPLEMENTATION OF RULE RELATING TO STAFFING STANDARDS FOR LONG-TERM CARE FACILITIES UNDER THE MEDICARE AND MEDICAID PROGRAMS. The Secretary of Health and Human Services shall not, during the period beginning on the date of the enactment of this section and ending September 30, 2034, implement, administer, or enforce the amendments made by the provisions of the final rule published by the Centers for Medicare & Medicaid Services on May 10, 2024, and titled “Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting” (89 Fed. Reg. 40876) to the following sections of part 483 of title 42, Code of Federal Regulations:(1) Section 483.5.(2) Section 483.35.

When the budget act passed, the moratorium made it impossible to apply the Biden administration’s rule of a registered nurse in every long-term care home for nearly a decade.

On Dec. 2, 2025, HHS and CMS announced they would revoke the rule. The “interim final rule with comment period” repealing Biden’s HHS rule appeared in the Federal Register with an effective date of Feb. 2, 2026, and an invitation for public comments during the two months between announcement and implementation.