A federal judge in Texas has tossed a Biden administration policy directing long-term care facilities, including most nursing homes, to change their staffing requirements to include 24-hour licensed nursing services at the facilities.
The Centers for Medicare and Medicaid Services issued the final rule in May 2024, citing a need to provide residents with safe and quality care, address insufficient staffing at facilities, and “create a consistent floor to reduce variability in the minimum floor for nurse-to-resident ratios.”
The rule came after COVID-19 ravaged nursing homes during the pandemic.
Soon after the policy was issued, in June 2024, several nursing home-related organizations sued the secretary of the Department of Health and Human Services and the administrator of the CMS. They argued that it “exceeds CMS’s statutory authority, effects a baffling and unexplained departure from the agency’s longstanding position, and creates impossible-to-meet standards that will harm thousands of nursing homes and the vulnerable Americans they serve.”
District Judge Matthew Kacsmaryk tossed the policy Monday, finding it inconsistent with Congress’s existing legislation. The filing included Health and Human Services Secretary Robert F. Kennedy Jr. as a defendant.
“Though rooted in laudable goals, the Final Rule still must be consistent with Congress’s statutes,” the court document reads. “To allow otherwise permits agencies to amend statutes though they lack legislative power. Separation of powers demands more than praiseworthy intent.”
The original lawsuit stated that the mandate would’ve required the services of a registered nurse 24 hours a day, seven days a week, which is different from Congress’s eight-hour, seven-day requirement.
“Over the years, Congress has considered alternative regulatory approaches, including proposals to replace the flexible sufficient-staffing requirement with a one-size-fits-all numerical minimum staffing requirement,” the lawsuit reads. “But each time, Congress has declined to adopt such proposals, and instead concluded that the adequacy of nursing home staffing should be determined flexibly based on the particularized needs of each facility.”
“This unrealistic staffing mandate threatened to close nursing homes and displace vulnerable seniors,” according to the American Health Care Association, one of the plaintiffs. “The court decision not only upholds the rule of law and balance of powers, but it protects access to care for our aging population.”
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Clif Porter, CEO of the American Health Care Association and National Center for Assisted Living, another plaintiff in the lawsuit, said the staffing mandate was “unrealistic” and “threatened to close nursing homes and displace vulnerable seniors.”
“The court decision not only upholds the rule of law and balance of powers, but it protects access to care for our aging population,” Porter said.
