SNFs remain obligated to plan for the mandate’s phased compliance requirements while monitoring legal and legislative developments that could vacate or rescind key provisions.
Accusations of ‘bare unlawfulness’ and riding roughshod over staffing at the Eighth Circuit
“The Northern District of Texas recently recognized the unlawfulness of the Rule’s staffing mandates, leading it to vacate the 24/7 registered nurse (RN) and staff-hours-per-resident day (HPRD) requirements,” Kansas Attorney General Kris Kobach wrote April 24. “As the Northern District of Texas rightly noted, the staffing mandates are an improper attempt to contravene Congress’s careful decision on nurse staffing for LTC facilities. The mandates’ bare unlawfulness, coupled with the Rule’s irreparable harm, warrants enjoining the whole Rule.”
— McKnight’s Long-Term Care News, April 29, 2025
Trump administration continues to defend nursing home staffing mandate in court
“It’s unfortunate that career DOJ lawyers must continue to try to defend this flawed and overreaching policy when the law is clear that CMS is exceeding its statutory authority. This is all the more reason for Congress, the administration, and the courts to put this issue to rest and protect access to care for our nation’s seniors.” — AHCA spokeswoman Rachel Reeves
— McKnight’s Long-Term Care News, April 7, 2025
SEIU Files Court Brief in Support of CMS Nursing Home Staffing Mandate
The nation’s largest labor representative of nursing home caregivers filed a brief opposing the lawsuit against the federal staffing mandate for nursing homes, arguing that the new requirements will help address the national shortage of staff at facilities.
The Service Employees International Union (SEIU) represents over 150,000 nursing home workers in 23 states.
— Skilled Nursing News, March 21, 2025
“Providers have a glimmer of hope. Judge Strand noted that the staffing rule could potentially be challenged as arbitrary and capricious, particularly if workforce-related arguments gain traction in later stages of litigation. However, any meaningful relief might be months or even years away.”
— McKnight’s Long-Term Care News, January 18, 2025
Judge denies request to halt staffing mandate
“[W]ith regard to nearly every aspect of the final rule, the plaintiffs have failed to demonstrate that a preliminary injunction is necessary in order to preserve the status quo and prevent irreparable harm,” wrote US District Judge Leonard T. Strand. “While the staffing requirements of the Final Rule will certainly impose financial burdens, the extent of the harm is simply too uncertain at this point.”
— McKnight’s Long-Term Care News, January 16, 2025
Judge Rejects Bid to Halt Nursing Home Staffing Rule
“[T]he interests of justice will be best served by proceeding quickly to the dispositive motions stage of this case, thus allowing the parties to address the merits directly, rather than through the lens of a motion for a preliminary injunction.” — Judge Leonard T. Strand
— Skilled Nursing News, January 16, 2025
“I think the most interesting issue here is the 24/7 requirement for RN coverage at LTCS, and the fact that Congress exercised its judgment to require at least eight consecutive hours a day, seven days a week,” Strand said. “It’s certainly a legitimate argument that when Congress has exercised that judgment as the elected body here, doing its job, weighing policies, coming up with at least eight hours consecutive a day, seven days a week — how does the agency and the secretary think they have the authority to increase that to 24/7?”
— McKnight’s Long-Term Care News, December 5, 2024
“Putting the rule on pause would give a little bit of breathing room just because that rule is not necessarily bearing down so definitively. It would create some relief of pressure in terms of hiring for the RN staffing mandate and the other staffing mandates in the rule, at least temporarily. … If they need to ramp up again, they can pretty easily.” — Attorney Anna St. John, representing private plaintiffs
— McKnight’s Long-Term Care News, December 5, 2024
After hearing the state’s arguments, Judge Leonard T. Strand of the U.S. District Court for Northern Iowa expressed uncertainty about granting a preliminary injunction, questioning whether delaying the rule might complicate recruitment efforts for providers if the rule is ultimately upheld. “There are reasons to expedite the situation, so I will work as quickly as I can,” he said at the conclusion of the hearing.
— Skilled Nursing News, December 5, 2024
Attorneys general will argue Thursday for staffing mandate injunction
“Despite Defendants’ best efforts to minimize it, there is no doubt that Plaintiffs have experienced and will continue to experience irreparable harm as a result of the Rule,” Kobach wrote. “Defendants on the other hand face no harm from the Court hitting the pause button on an unlawful Rule while allowing the case to reach final judgment. The Court should grant an injunction that is nationwide in scope.”
— McKnight’s Long-Term Care News, December 4, 2024
DOJ Pushes For Preliminary Injunction Denial in Nursing Home Staffing Mandate Lawsuit
“I think the biggest wins for the industry in regard to the mandate potentially are the results of this past election and the end of the Chevron deference,” said attorney Craig Conley. “Both should assist the challenges to the mandate and potentially end it all together.” The DOJ argued that the mandate fits “squarely within” the agency’s authority to protect the health and safety of residents and does not conflict with any portion of the statute.
— Skilled Nursing News, November 25, 2024
“LTCs that have not already hired staff to comply with the Final Rule soon will do so, and those costs impose significant, and in many cases, impossible, burdens on LTCs. Those burdens are especially harmful in those in rural areas in which the required workforce simply doesn’t exist or in other tight labor markets where LTC facilities compete with hospitals and other higher-paying healthcare jobs for scarce healthcare professionals.” — State attorneys general filing
— McKnight’s Long-Term Care News, October 28, 2024
State healthcare authority joins lawsuit against staffing requirements
“With the last payroll-based journal data, which is the data nursing facilities submit to CMS, the last quarter we have data for there were four [South Dakota] facilities out of 94 that would comply with the 24-hour RN rule,” said Justin Hinker, SDAHO VP of post-acute care. “Probably more so in our rural areas it would affect those facilities, but I think it is across South Dakota.”
— SDPB, October 10, 2024
