On April 7, 2025, a federal district court in Texas ruled that the Centers for Medicare & Medicaid Services (CMS) exceeded its statutory authority and violated the language of the Nursing Home Reform Law when it issued a final nurse staffing rule requiring registered nurses around the clock and at least 3.48 hours per resident day (HPRD) of nurse staffing time. American Health Care Association, et al v. Kennedy, Nos. 2:24-CV-114-Z-BR and 2:24-CV-171-Z (consolidated) (Amended Complaint) (N.D. Texas, Jun. 18, 2024). See “Federal Court in Texas Vacates President Biden’s Staffing Rule for Nursing Homes” (CMA Alert, Apr. 10, 2025).
On June 2, 2025, the federal government appealed that decision.
A second case challenging the staffing rule, State of Kansas v. Becerra, Civ. A. 1:24-cv-00110-LTS-KEM (N.D. Iowa, Oct. 8, 2024), is pending in Iowa. On January 16, 2025, the court denied plaintiffs’ motion for a preliminary injunction to stop implementation of the rule. “Court Denies Preliminary Injunction in Challenge to Nursing Home Staffing Rule” (CMA Alert, Jan. 16, 2025). The Center led a coalition of organizations in an amicus brief that urged the court to allow the staffing rule to take effect. The government’s April 3 brief in the Eighth Circuit, State of Kansas v. Kennedy, No. 25-1097, strongly supported the staffing rule.
Many advocates for nursing home residents believe that the Federal Government’s filings in the Texas and Iowa cases do not reflect actual support for the staffing rule, but, rather, an interest in keeping the rule alive so that the savings from the Congressional delay of the rule for 10 years could be applied to the Medicaid cuts that Congress is requiring in the budget reconciliation process.
June 5, 2025 – T. Edelman