The mandate’s fate now turns on parallel tracks: the Fifth Circuit appeal, ongoing Eighth Circuit litigation in Iowa, and a Congressional moratorium proposal included in the budget reconciliation bill.
Feds continue court fight to keep nursing home staffing mandate
The Department of Health and Human Services notified the US District Court for Northern Texas Monday that it is taking the case to the Fifth Circuit of Appeals for a second opinion. District Court Judge Matthew J. Kacsmaryk threw out hourly minimum staffing rates and a requirement for 24-hour a day registered nurse coverage on April 7. He said the Centers for Medicare & Medicaid Services lacked the authority “to issue a regulation that replaces Congress’s preferred minimum hours with its own.”
— McKnight’s Long-Term Care News, June 3, 2025
‘Placeholder’: Legal Experts Weigh In as HHS Appeal Revives Nursing Home Staffing Mandate
“I highly doubt that this development means anything consequential at the moment,” Reagan told Skilled Nursing News. “There is a strong desire to bank the savings associated with the staffing mandate as part of the Reconciliation process. It was therefore essential for the judgment to be appealed in order to preserve that opportunity. As such, I see the notice as nothing more than a placeholder at present.”
— Skilled Nursing News, June 3, 2025
Turning the page from mandates to solutions
The recent decision from the Northern District court in Texas to overturn the minimum staffing rule marks a critical turning point for senior care. It not only lifts an unrealistic and rigid mandate but also paves the way for a more thoughtful approach and innovative solutions to enhance quality, support our caregivers, and ensure the long-term sustainability of rural long-term care providers.
— McKnight’s Long-Term Care News, April 23, 2025
Federal court strikes down minimum staffing rule: The details you might not know behind the decision
The District Court held that agencies can act only within the power given to them by Congress. Here, CMS effectively altered Congress’ statute by imposing the staffing minimum federal rule. “Addition is not subtraction. Agencies may add to statutes consistent with their delegated authority and other laws. They may never cut statutes to replace them with their own requirements.”
— McKnight’s Long-Term Care News, April 21, 2025
Legacy even in defeat? Nursing home experts anxious about next moves on staffing efforts
“The main lasting legacy of this rule is just the highlighting of the workforce issue, the workforce crisis, in healthcare,” said Steve LaForte, chief legal officer and executive vice president of corporate affairs for Idaho-based Cascadia Healthcare. “That’s what we need to focus on — all the actors involved. Whether it’s CMS, HHS, Congress, the administration, state health and welfare agencies, unions, operators, we don’t come up with a solution unless all the parties are involved.”
— McKnight’s Long-Term Care News, April 21, 2025
In a closely watched ruling, Judge Matthew J. Kacsmaryk of the U.S. District Court for Northern Texas struck down a controversial Centers for Medicare & Medicaid Services rule that would have required every facility to have a registered nurse on duty 24/7. His decision wasn’t just a win for advocacy. It was a direct result of a seismic legal shift nearing its second anniversary — the Supreme Court’s rejection of the Chevron doctrine.
— McKnight’s Long-Term Care News, April 13, 2025
A shot heard round the nursing home world
Whether that win, essentially vacating the rule’s hourly standards for direct patient care and a 24/7 RN requirement, proves to be truly decisive remains unknown. It might be just what’s needed to win this battle, but it also could be the shot across the bow that keeps consumer groups on the warpath long-term.
— McKnight’s Long-Term Care News, April 9, 2025
Federal Judge Strikes Down CMS Nursing Home Staffing Mandate: What It Means for Senior Living
“The senior living industry is already contending with historic workforce shortages,” said Maggie Elehwany, Senior Vice President, Public Affairs with Argentum. “Mandating minimum staffing requirements for one segment of long-term care providers, without addressing workforce pipeline challenges, risks pulling from the same finite pool of workers — and undermining access to care for seniors across the continuum.”
— Argentum, April 8, 2025
“This is a really strong decision on both prongs of the staffing mandate. It hits all of the relevant points as to how the ‘unflinching’ mandate seeks to alter what Congress set in place,” Mark Reagan, managing shareholder at Hooper, Lundy & Bookman, told Skilled Nursing News. “The rule does not supplement, it contradicts. If appealed, I am very confident that the District Court’s judgment will be upheld by the Fifth Circuit Court of Appeals.”
— Skilled Nursing News, April 8, 2025
UPDATED: Judge tosses nursing home staffing rule in ‘major victory’ for sector
“CMS lacks authority to issue a regulation that replaces Congress’s preferred minimum hours with its own. That is exactly what the 24/7 Requirement does,” Kacsmaryk wrote in his Monday ruling in favor of the nursing home plaintiffs. “Congress took it upon itself to set the minimum hours nursing homes ‘must use the services of a registered professional nurse.'”
— McKnight’s Long-Term Care News, April 7, 2025
Federal Judge Tosses Nursing Home Staffing Rule as Trump Admin Defends it in Court Filing
“Though the final rule attempts to remedy chronic nursing home deficiencies, it does so deficiently,” said Kacsmaryk. “The final rule still must be consistent with Congress’s statutes. To allow otherwise permits agencies to amend statutes though they lack legislative power. Separation of powers demands more than praiseworthy intent.”
— Skilled Nursing News, April 7, 2025
