![[UPDATED] CMS Proposes Rule To Reduce Nursing Home And Health Care Burdens, Save $320M](https://threeheartshome.com/wp-content/uploads/2026/11/updated-cms-proposes-rule-to-reduce-nursing-home-and-health-care-burdens-save-32-featured.jpg)
TL;DR
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CMS has proposed changes to reduce administrative requirements across 21 types of health care providers and suppliers, estimating $320 million in savings and 3.26 million staff hours returned. Nursing home proposals include removing certain Medicaid payment reports and changing some COVID-19 requirements; the rule is not final, and public comments are expected to shape it.
The Centers for Medicare and Medicaid Services issued a proposed rule Thursday to remove or revise selected administrative requirements across health care, including rules affecting nursing homes, and estimates the changes would save $320 million and return more than 3.26 million staff hours to providers. The proposal, called Cutting Administrative Requirements for Excellence in Patient Care (CARE), is not final and would require further federal action after public input.
CMS said its proposals followed a review of regulations covering 21 provider and supplier types. The agency described the targeted rules as obsolete, outdated or excessively burdensome, and said its aim is to free resources providers could use to improve patient health and safety. The estimated savings and staff hours apply across the health care continuum, not solely to nursing homes.
For nursing facilities and intermediate care facilities for individuals with intellectual disabilities, CMS proposes eliminating three Medicaid payment transparency reporting requirements. They cover reporting the share of Medicaid payments used for direct-care worker compensation and support-staff compensation in nursing facilities, and support-staff compensation in intermediate care facilities. CMS says removing the reports would reduce administrative work for states and providers.
The proposal would also align remaining COVID-19 vaccination requirements for residents with requirements for other respiratory viruses. CMS is seeking input on whether residents should be able to opt out of having discharge notices sent to state ombudsman offices. It is also asking about expanding nurse practitioners’ and physician assistants’ scope of practice in long-term care, including whether they could conduct visits now required to be performed by physicians.
How the Changes Could Affect Nursing Homes
If adopted, the changes could reduce reporting and other administrative tasks for facilities and state agencies, potentially giving staff more time for care-related work. CMS’s estimate of 3.26 million hours returned, however, covers the full range of providers and suppliers considered in the rule; the supplied report does not break out the expected savings for nursing homes.
The payment-reporting proposal has drawn a more complicated response from the sector. Jodi Eyigor, vice president of health policy at LeadingAge, said a narrow focus on the share of Medicaid payments used for staff compensation could miss other legitimate expenses tied to care and safety. She also warned that removing reporting should not weaken efforts to identify “tunneling”—the diversion of facility resources to owners, operators or affiliated parties. The debate is over how to reduce paperwork without losing useful financial oversight.
Changes to infection reporting, vaccination procedures and professional practice rules could also affect how facilities organize compliance and care. The proposal seeks input on several of these areas, so their eventual form and practical effects remain open.
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The Proposal’s Pandemic-Era Requirements
The CARE proposal includes changes to requirements established or maintained during the COVID-19 public health emergency. The Skilled Nursing News report says CMS aims to end weekly reporting requirements associated with that emergency and proposes removing National Healthcare Safety Network reporting requirements for nursing homes. LeadingAge said the NHSN reporting duplicated other infection-control processes and that removing it would not mean losing information about local threats to residents and staff.
Clif Porter, president and CEO of the American Health Care Association and National Center for Assisted Living, also welcomed the proposed end to weekly reporting tied to the emergency, describing it as a way to reduce redundant administrative tasks. He said the association planned to comment on the proposal, including on measures addressing caregiver shortages.
The rule also proposes changes to staff education, vaccine offers and documentation related to COVID-19 vaccination. Those provisions, like the reporting changes, remain proposals rather than current requirements. CMS has asked for comments on potential future policies addressing shortages in the institutional Medicaid workforce.
“CMS identified obsolete, outdated, and excessively burdensome regulations that it proposes to eliminate or reform.”
— Centers for Medicare and Medicaid Services, in the CARE fact sheet
Details Still Open for Public Comment
The rule is a proposal, not a final policy. The supplied report does not state the deadline for public comments, when CMS expects to issue a final rule, or whether the agency will adopt the provisions as written.
CMS’s overall savings estimate is not separated by provider type in the source material, leaving unclear how much of the projected $320 million or 3.26 million hours would be attributable to nursing homes. The final scope of changes to payment reporting, vaccination procedures, ombudsman notices and clinician visits also remains undetermined.
There is also no agreement in the cited comments on how to balance less reporting with oversight of Medicaid spending. LeadingAge supports reducing a compensation-focused reporting approach but says policymakers still need tools to detect tunneling. The proposal’s effect on that oversight will depend on what CMS retains or changes in the final rule.
CMS Reviews Stakeholder Feedback
CMS is seeking public input on the proposed changes, including the nursing home provisions and possible policies addressing institutional workforce shortages. LeadingAge and AHCA/NCAL said they intend to submit comments. CMS will need to review feedback before deciding which proposals to finalize, revise or drop.
The next milestones are the close of the comment period and publication of a final rule. The supplied report does not give dates for either. Until CMS issues final requirements, facilities and states should treat the described changes as proposed rather than as instructions already in force.
Key Questions
What is CMS proposing?
CMS proposes removing or revising selected administrative rules across 21 provider and supplier types. Provisions affecting nursing homes include ending certain Medicaid payment reports and changing some COVID-19-related requirements.
How much does CMS estimate the proposal would save?
CMS estimates $320 million in savings and more than 3.26 million staff hours returned across the health care continuum. The supplied report does not provide a nursing-home-only estimate.
Would the Medicaid payment reporting changes take effect now?
No. They are part of a proposed rule. CMS must review public comments and issue a final rule before any adopted changes take effect.
Why has the reporting proposal drawn concern?
LeadingAge’s Jodi Eyigor said compensation-focused reports may not show the full range of legitimate spending on care and safety. She also said policymakers need effective ways to identify tunneling, in which funds may be diverted from facility care to owners or affiliated parties.
What happens next?
CMS will collect and review public comments. The report gives no comment deadline or final-rule date, so the timing and ultimate content of the requirements remain unclear.
Source: skillednursingnews.com
