Still poring through nearly 47,000 comments, federal regulators have conceded it may take up to three years to finalize a nursing home staffing rule.

The Fall 2023 Unified Agenda sets September 2026 as the deadline to finalize the standards proposed in September 2023. The rule would require nursing homes to revamp facility assessments; meet hourly thresholds per-patient, per-day for certified nurse aides and registered nurses; and staff RNs around the clock.

The Centers for Medicare & Medicaid Services must review each comment before moving forward with a final rule. In the Unified Agenda — published by the White House Office of Management and Budget in December — officials indicate the review could take longer than the year estimated by some nursing home advocacy groups. 

But the agency said it did “not intend to delay publishing … if we are able to publish it sooner.”