It turns out, you can’t regulate your way out of a workforce shortage.

That’s the message the Centers for Medicare & Medicaid Services just got from a federal judge in Iowa, who did what many skilled care operators had been hoping for: He hit pause on the most unrealistic parts of the staffing mandate. The 24/7 RN requirement and rigid nurse staffing rule minimums are now off the table — at least for now.

US District Judge Leonard Strand didn’t strike down the rule in its entirety. Some elements, like facility assessments and Medicaid reporting, still stand. But make no mistake: This is a major course correction.

And frankly, it’s about time.

No one is arguing against strong staffing in nursing homes. Quality care demands adequate staff — everyone agrees on that. But CMS’s push to mandate round-the-clock RN coverage and strict per-resident staffing quotas simply didn’t align with workforce realities. Not now, and not anytime soon.

Staffing shortages aren’t theoretical. They’re a daily challenge, driven by wage pressure, burnout, and a post-pandemic labor market that’s still far from stable. Add in, yes, some frugality among operators, and the staffing picture becomes even more complicated.

Layering on federal mandates that even high-performing providers couldn’t meet was never going to improve care. What it was likely to do is push hundreds of facilities toward closure.

And let’s be clear: Many at-risk facilities weren’t low performers. They were small-town homes, mission-driven nonprofits, and rural providers barely hanging on. For them, this ruling doesn’t just offer relief. It may be the difference between staying open or shutting their doors.

The court’s decision doesn’t fix the staffing crisis. But it helps slow the bleeding. And maybe, just maybe, it opens the door to more thoughtful solutions — ones grounded in the day-to-day realities facing providers, not just regulatory optimism.

Because as Judge Strand made clear with his staffing rule decision, even the best intentions can go sideways when common sense gets left behind.

John O’Connor is editorial director for McKnight’s.

Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.