On Monday, a US District Court judge in Texas threw on Biden-era policies to increase staffing for long-term care facilities participating in Medicaid or Medicare programs.
In May 2024, under former President Joe Biden's administration, the Centers for Medicare and Medicaid Services issued a final rule requiring facilities that include approximately 97% of nursing homes, and changed staffing requirements by providing 24-hour licensed nursing services at facilities.
The mandate came after the Covid-19 pandemic had a major impact on nursing homes and raised questions about whether sufficient is being done to care for the institution's residents.
The Biden administration said it has established federal minimum nurse staffing standards to provide safe and quality care to residents, address inadequate staffing at facilities, and “create consistent floors to reduce the lowest levels of nurse-to-residential ratio variation.”
In response to the policy, the American Medical Association, the Texas Health Care Association, and other nursing home organizations filed lawsuits in June against the U.S. Secretary of Health and Human Services and the administrator of the Centers for Medicare and Medicaid Services (CMS). In the Northern District of Texas, the plaintiffs argue that “extend CMS statutory authorities, to influence the agency's longstanding position of embarrassment and unexplained departures, creating standards that do not harm thousands of nursing homes and the vulnerable Americans they serve.”
The lawsuit states that the obligation to use registered nurse services 24 hours a day, seven days a week is a departure from the standing law where the Congress original directive trips seven days a week for seven days, leaving it to each facility to determine what residents need.
“For many years, Congress has considered alternative regulatory approaches, including proposals to replace flexible, ample staffing requirements with a single size numerical minimum staffing requirement,” the lawsuit states. “However, each time, Congress refuses to adopt such proposals and instead concluded that the validity of nursing home staffing should be flexibly determined based on the specific needs of each facility.”
On Monday, U.S. District Judge Matthew Caxmalick abandoned Biden administration policies, citing it as conflicting with existing legislation in Congress. The submission included current health and welfare secretary Robert F. Kennedy Jr., among others, as defendants.
“Though rooted in a commendable goal, the final rules still need to be consistent with Congressional law,” the court documents state. “Otherwise, they lack legislative authority to allow agencies to amend the law. The separation of power demands more than admirable intentions.”
The White House did not immediately respond to a request for comment.
The American Health Care Association (AHCA), which represents around 15,000 long-term care facilities and nursing homes across the United States, called the ruling Monday a “winning for seniors in our country and their families.”
“This unrealistic staffing mission has threatened to close nursing homes and drive away vulnerable elderly people,” the AHCA said. “The court's decision not only maintains a balance between the rule of law and authority, but also protects access to care for seniors.”
The AHCA said it looks forward to working with Congress and President Donald Trump's administration.
