Judge Matthew Kacsmaryk of the U.S. District Court for Northern Texas has vacated a yet-to-be-imposed nursing home staffing level mandate approved during the Biden administration.
The judge’s ruling encompasses two separate but consolidated lawsuits: one filed by the American Health Care Association and the American Health Care Association-National Association of Home Care Providers, and the other filed by Texas Attorney General Ken Paxton on behalf of the state of Texas.
LeadingAge, a nonprofit aging services provider, and a handful of Texas nursing homes joined the suit after its original filing.
Clif Porter, president and CEO of AHCA, said the ruling was a “victory for our nation’s seniors and their families,” according to an April 7 news release from the organization.
“This unrealistic staffing mandate threatened to close nursing homes and displace vulnerable seniors,” he said in the release. “The court decision not only upholds the rule of law and balance of powers, but it protects access to care for our aging population.”
The staffing mandate, set to take effect in 2026, would have been rolled out in three phases over a three-year period.
The mandate required long-term care facilities to have a registered nurse on site for 24 hours per day, seven days a week, as opposed to the current requirement of eight hours per day, seven days a week.
It also required total nurse staffing of at least 3.48 hours per resident day, registered nurse staffing of at least .55 hours per resident day and nurse aide staffing of at least 2.45 hours per resident day.
The American Hospital Association supported Mr. Paxton’s original suit in an amicus brief.
“Imposing inflexible numerical thresholds on long-term-care facilities will lead to worse patient outcomes and less patient-care capacity across the entire healthcare system,” the AHA brief said.
In his ruling, Judge Kacsmaryk said requiring facilities to have a registered nurse on site for 24 hours per day, seven days a week “exceeded the authority” of CMS.
CMS launched a nursing home staffing campaign in December to address industry concerns surrounding the mandate. Part of the campaign includes offering eligible nursing homes the opportunity to apply for a Financial Incentive Administrator designation, allowing facilities to receive funding for the recruitment and retention of registered nurses.
Twenty other states and 19 nonprofit organizations filed a lawsuit against HHS and CMS in the U.S. District Court for the Northern District of Iowa over the mandate. In January, Judge Leonard Strand denied the suit’s request for an injunction against the rule, according to a Jan. 17 Des Moines Register report.
