Attorney General Bonta Leads with Compassion, Stands Up for Seniors Across America

OAKLAND — Co-leading a multistate coalition of 18 attorneys general, California Attorney General Bonta today filed a comment letter that challenges the federal government’s Interim Final Rule, intended to eliminate minimum staffing standards and other comprehensive regulations for long-term health care facilities. Originally established by the Nursing Home Reform initiative, new and improved standards were federally developed and designed to create national requirements for a minimum number of nursing hours in skilled nursing facilities, including minimum staffing requirements for medical professionals like registered nurses. In the comment letter, the coalition foregrounds that with these reforms having been overturned by the One Big Beautiful Bill Act, regulations still must exist to improve quality of care and patient health outcomes for residents in skilled nursing facilities across the United States.

“The Trump Administration is encouraging care homes to operate at bare minimum staffing that strips elders of support when they need it most. It is the opposite of compassionate, it is morally bankrupt,” said Attorney General Bonta. “Repealing existing standards is reckless and compromises public health, safety, and outcomes of residents in these care facilities, disproportionately affecting elders and minority communities. We urge the federal administration to prioritize the well-being of seniors over financial considerations.”

The Nursing Home Reform initiative was instituted by the Biden-Harris administration in May of 2024 at the suggestion of the Centers for Medicare & Medicaid Services at the Department of Health and Human Services. The initiative created a minimum staffing standard for nursing hours per resident day, required every facility to have registered nurses to provide care on site 24/7, and a minimum staffing standard for hours worked by certified nurse assistants. Studies and statistics show that increased numbers of staff and the quality of staff associated with the reform manifest in improvement to the quality of care, increased attentiveness, mitigation of negative outcomes, and savings of up to $465 million dollars in Medicare by reducing medical emergencies and hospitalizations.

In the comment letter, the multistate coalition asserts that:

• Data proves that increased staffing of nurses, as well as mandatory requirements for the presence of RNs on site, is associated with positive health outcomes for facility residents.
• Because some states, such as California, New York, and Massachusetts, have already established staffing requirements, eliminating regulations at the national level widens the interstate gap in quality of care.
• The proposed Interim Final Rule needs to adopt replacement staffing standards to prevent long-term care establishments from cutting costs and corners at the expense of their patients already vulnerable to abuse and abandonment.
• All regulations proposed by the CMS should not preempt existing or future state standards that seek to provide higher protections to residents.

In filing the comment letter, Attorney General Bonta was joined by the attorneys general of Arizona, Colorado, Delaware, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, and Washington.

The Division of Medi-Cal Fraud and Elder Abuse receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $77,652,892 for Federal Fiscal Year (FFY) 2026.  The remaining 25 percent, totaling $25,884,297 for FFY 2026, is funded by the California Attorney General’s Office.  FFY 2026 is from October 1, 2025 through September 30, 2026.