Federal Court Strikes Down Nursing Home Staffing Mandate

• A federal court recently struck down the nursing home staffing mandate that was being implemented under the previous White House administration. 
• Two organizations that brought the suit called it a victory, stating that the staffing rule from the Centers for Medicare and Medicaid Services exceeded the organization’s authority. 
• However, the current White House administration’s legal team just defended the staffing mandate against a separate suit. 

A nursing home staffing mandate issued under the previous White House administration could be a moot point. 

The U.S. District Court of Northern Texas ruled in favor of the American Health Care Association/National Center for Assisted Living, LeadingAge, and four nursing homes that filed suit against the mandate, arguing it violated the Administrative Procedures Act and was outside the Centers for Medicare and Medicaid Services’ scope of authority. 

Regulatory actions from CMS “must be consistent with Congress’s legislation governing nursing homes” and the CMS final ruling wasn’t, according to Judge Matthew J. Kacsmaryk.  

“Though the final rule attempts to remedy chronic nursing home deficiencies, it does so deficiently,” court documents state. “It requires nursing homes participating in Medicare or Medicaid to have a registered nurse on staff at least 24 hours a day, although Congress set the baseline at eight hours a day. And it attempts to require every participant nursing home to achieve minimum staffing hours only based on a facility’s number of residents, although Congress mandated consideration of a facility’s individual nursing needs.” 

Federal Court Ruling Considered a ‘Victory’ 

Clif Porter, president and CEO of AHCA/NCAL, called the ruling a “victory for our nation’s seniors and their families” and said the mandate was unrealistic.  

“In light of evolving care practices and our nation’s changing demographics, federal policymakers should not be dictating staffing hours but encouraging innovation and high-quality outcomes,” he said in a statement. “The staffing mandate is a 20th Century solution that should be blocked by Congress once and for all.” 

LeadingAge President and CEO Katie Smith Sloan also released a statement on the ruling, saying that imposing mandates instead of addressing funding and workforce issues is “wrong-headed.” 

RELATED: New Lawsuit Filed in Opposition to Federal Nursing Home Staffing Mandate 

“Quality care and staffing go hand-in-hand,” she said. “Without dedicated nurse aides, registered nurses, licensed practical nurses, and other essential staff, care simply cannot happen. This overreaching rule was misguided, and today’s ruling demonstrates the importance of a thoughtful, sustainable path forward that supports both care quality and workforce development.” 

The lawsuit, filed last May, alleged the mandate exceeded CMS’s authority. Nursing home staffing was thrust into the spotlight in late 2023 as part of the then-White House Administration’s Action Plan for Nursing Home Reform.  

The American Nurses Association has vocalized support for the staffing mandate in the past but has yet to release a statement regarding the court ruling. 

Some Questions on Mandates, Lawsuits Remain 

Despite organizations touting victory, the current White House administration’s lawyers defended the mandate just one week ago in response to a separate lawsuit filed in the Eight Circuit Court of Appeals. McKnights Long-Term Care News reported that the attorneys argued that CMS “did not exceed its legal authority.” 

That suit was brought by 20 attorneys general who argued the staffing mandate was an “attack on senior care” that would force facilities to close, decrease access for seniors, and increase costs. 

McKnights and Skilled Nursing News have detailed the potential effects related to the attorneys general lawsuit, with some suggesting the final rule could be rescinded as part of efforts to slash the federal budget. 

The Bottom Line

The U.S. District Court of Northern Texas has ruled in favor of the AHCA/NCAL, LeadingAge, and four nursing homes that filed a lawsuit against the previous White House administration’s nursing home staffing mandate. However, other lawsuits related to the ruling are still making their way through the courts, with the current White House administration’s legal team defending the mandate. It’s unclear at this time how those suits will affect the staffing mandate.  

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