Nursing homes sue to block staffing mandate

 Nursing homes sue to block staffing mandate

Photo: Catherine Falls Commercial/Getty Images

The American Health Care Association and other groups representing nursing homes have filed a lawsuit against the Department of Health and Human Services to block staffing mandates.

The lawsuit was brought in federal court in the Northern District of Texas on Thursday by the American Health Care Association, the Texas Health Care Association, Arbrook Plaza, Booker Hospital District and Harbor Lakes Nursing and Rehabilitation Center.

On May 10, the Centers for Medicare and Medicaid Services issued a rule imposing minimum staffing requirements on nursing homes that the plaintiffs call “onerous.”

The rule exceeds CMS’s statutory authority and creates impossible-to-meet standards that will harm thousands of nursing homes and the vulnerable Americans they serve, the lawsuit said.

The groups want the court to vacate the rule.


During COVID-19, attention was called to the number of nursing home residents who lost their lives during the pandemic. CMS Administrator Chiquita Brooks-LaSure said nursing home residents and staff made up roughly one-fourth of all COVID-19 deaths in the country. 

President Biden called upon Medicare to do more. In his State of the Union address in 2022, Biden said he wanted Medicare to set higher standards for nursing homes. CMS responded with a final rule on staffing released last month.

The final rule replaces a nursing home directive to employ an RN for eight consecutive hours, seven days a week, with CMS’s mandate to have an RN onsite 24 hours per day, for seven days a week. It demands that every facility across the nation provide total nurse staffing of at least 3.48 hours per resident day, including RN staffing of at least 0.55 hours per resident per day and nurse aide staffing of at least 2.45 hours per resident per day.


Decades ago Congress established staffing mandates for nursing homes: that they must use the services of a registered nurse for at least eight consecutive hours per day, seven days a week; and that the nursing home must provide 24-hour licensed nursing services, the lawsuit said.

Over the years, Congress considered other regulations, but declined to adopt such proposals. Instead lawmakers concluded that nursing home staffing should be determined flexibly based on the particular needs of each facility, the lawsuit said.

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Fallon Wolken

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