Christian Smith
Tina Sandri, CEO of Forest Hills of DC senior living facilities, left, helps resident Courty Andrews return to her room, December 8, 2022, in Washington. (AP Photo/Nathan Howard)
An industry lawsuit is urging a federal court to overturn the Biden administration’s new mandatory minimum staffing requirements for nursing homes, arguing that the federal Medicare agency exceeded its authority.
The complaint argues that Congress never gave the Centers for Medicare and Medicaid Services (CMS) the authority “to impose such onerous and unattainable mandates on virtually every nursing home in the country,” so the rules are a violation of the Administrative Procedure Act. .
The request was filed last week in the Northern District of Texas by the American Health Care Association (AHCA), its Texas counterpart, and the operators of three nursing homes in the state.
“Establishing one-size-fits-all staffing requirements that will require about four-fifths of the nation’s nursing homes to hire additional staff, even though almost no state has found these higher levels necessary… is the height of the agency’s arbitrary and capricious action,” stated the complaint.
The suit argues that the requirements will force the closure or downsizing of facilities, displacing tens of thousands of residents and “forcing countless other seniors and family members to wait longer, look further and pay more for the care they need.”
Under requirements revealed last month, all nursing homes that receive federal funding through Medicare and Medicaid will have to have a registered nurse on staff 24 hours a day, seven days a week and provide at least 3.48 hours of nursing care per resident per day.
The rules will cost nursing homes $43 billion over the next decade, according to estimates from the Department of Health and Human Services (HHS).
The rule’s requirements will be introduced in phases, with longer lead times for rural communities. Limited and temporary exemptions will be available to both the 24/7 registered nurse requirement and the underlying staffing standards for nursing homes in areas with labor shortages that demonstrate a good faith effort to to hire.
Non-rural facilities must meet the requirements by May 2027, and rural facilities have five years, until May 2029.
But, according to the lawsuit, the staffing requirements “defeat the basic principles of administrative law in every respect.”
“We hoped it wouldn’t come to that; we have repeatedly sought to work with management on more productive ways to increase the nursing home workforce,” said Mark Parkinson, president and CEO of AHCA, in a statement.
Notably, the lawsuit was filed in federal court in Amarillo, Texas. Texas is a popular location for groups seeking favorable rulings against the Biden administration, and the Amarillo district court has just one judge, Matthew Kacsmaryk.
Kacsmaryk, appointed by former President Trump, is the same judge who suspended approval of the abortion pill mifepristone and ruled against the Biden administration on several other issues, including immigration and LGBTQ protections.
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