Diving briefs:
On Monday, a federal judge in Texas defeated controversial Biden-era policies. This attempted to increase staffing in nursing homes and registered nurses attempted to request nurses who are registered around the clock. Judge Matthew Caxmalick said the policy was “admired” in its goal of improving the quality of nursing homes, but said HHS ultimately surpassed its authority in issuing the rules. The plaintiffs, nursing home trade organizations, including the American Medical Association and Leading Age, supported the decision on Monday. The group argues that staffing requirements are too cumbersome and could lead to the closure of nursing homes.
Dive Insights:
Since its establishment in 2023, the mandate of landmark staffing has not been popular among both industry groups and some politicians.
The CMS estimates that 79% of nursing homes will need to increase employment to meet the requirement of providing 3.48 hours of patient care per day, while KFF predicts that 81% of facilities will have to hire additional staff.
The mission is likely to be expensive too. CMS predicted industry costs will range from $1.5 billion to $6.8 billion to meet employment targets.
Before the Biden administration completed the rules in April 2024, some lawmakers urged the CMS to consider the negative impacts on veteran care if they introduced a bill that would help care for shutters in nursing homes and prevent the rules from being finalized.
Still, the policy has moved forward.
According to the Biden administration, the rules were intended to address quality concerns revealed during the Covid-19 pandemic.
The administration intended to facilitate the burden of provider implementation by gradualizing the rules over three years for non-rural providers and five years for rural providers. However, trade groups and some politicians still pushed back policy.
Both the state of Texas and the nursing home organization sue HHS and CMS in Northern Texas District Court last year to block the rules.
Kaxmalick, who presides the court, was appointed by Trump and ruled in favor of a frequently regulated agenda. Independent watchdog organizations and the media accused the plaintiffs of shopping before a conservative judge.
In this case, Kacsmaryk said he was sympathetic to the Biden administration's desire to improve the quality of care in nursing homes, but said the rules stomped Congress in creating the 24-7 registered nurse requirements. The judge noted that Congress had specifically considered whether or not to implement such requirements before, and that he chose not to do so, both when the committee considered similar proposals and when Congress granted a bill that advanced 24-7 nursing policy.
“The court's ruling not only maintains a balance between the rule of law and power, but also protects access to care for an elderly population,” Clif Porter, president and CEO of AHCA and CEO of the National Center for Assistance of Living, said in a news release.
Katie Smith Sloan, president and CEO of Leadingage, agreed, “It would have had a serious impact on the ability of nursing home members to provide the care and services provided by providers in other care settings, such as home health and hospice,” said Leadingage's president and CEO, “ignoring the key interdependence of funding, care, staffing and quality.”
HHS did not immediately respond to requests for comment.
