Texas is suing the Biden administration over a new policy mandating minimum staffing levels in nursing homes, arguing the federal Medicare agency exceeded its authority.
In a lawsuit filed Wednesday in the Northern District of Texas, state Attorney General Ken Paxton, a Republican, said the rule should be struck down and the administration should be permanently blocked from enforcing it.
“This power grab by Biden’s health bureaucrats could force desperately needed medical facilities out of business in some of our state’s most underserved areas,” Paxton said in a statement. “We are suing the federal government over this rule, which threatens to close facilities with unfilled new job slots and exacerbate rural health care shortages.”
The lawsuit argues that Congress has repeatedly refused to change nursing home staffing requirements and that the Centers for Medicare and Medicaid Services lacks the authority to ignore Congress’ intent.
“The new requirements remove the flexibility that nursing homes previously had to determine whether their facilities are ‘sufficient to meet the care needs of their residents.’ Instead, the CMS final rule imposes a one-size-fits-all rule with rigid, inflexible requirements that are in direct violation of Congress’ expressed flexible mandate,” the lawsuit states.
Requirements announced earlier this year will require all nursing homes that receive federal funding through Medicare and Medicaid to have a registered nurse on-site 24 hours a day, seven days a week to provide at least 3.48 hours of nursing care per resident per day.
The Department of Health and Human Services (HHS) estimates that the regulations will cost nursing homes $43 billion over the next decade.
The rule’s requirements will be phased in over time, with longer periods in rural communities, and limited, temporary waivers will be allowed for both the 24/7 registered nurse requirement and the staffing standards that demonstrate good faith hiring efforts in nursing homes in shortage areas.
Non-rural facilities have until May 2027 to meet the requirements, while rural facilities have a five-year period until May 2029.
But Texas says the policy could lead to rural nursing home closures and would force nursing homes across the state to “hire over 10,000 highly specialized qualified personnel overnight, more than are currently available in the labor market in the state and within specific service areas.”
The lawsuit was filed in federal court in Amarillo, Texas, which is presided over by a single judge, Judge Matthew Kacsmarik.
The American Healthcare Association, a trade group, filed a similar lawsuit in the same district in May.
Judge Kacsmalik, who was appointed by former President Trump, is the judge who suspended approval of the abortion drug mifepristone and has ruled against the Biden administration on several other issues, including immigration and LGBTQ protections.
