Nursing Homes Sue To Block HHS Staffing Mandate

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Dive Brief:

• Nursing home groups have sued the HHS and CMS to block the Biden administration’s new nursing home staffing mandate, which is deeply unpopular with the industry.
• Under the rule, which was finalized last month and is scheduled to take effect in August, long term care facilities must provide 3.48 hours of care per resident per day and have a registered nurse on duty at all times. The CMS predicted 79% of long term care facilities nationwide would have to increase hiring to meet requirements.
• The leading plaintiffs — the American Health Care Association and the Texas Health Care Association — claim the rule’s “onerous” requirements will exacerbate the industry’s staffing crisis and could disrupt patients’ access to care in the lawsuit filed in federal court last week.

Dive Insight:

The COVID-19 pandemic exposed longstanding problems with care quality at nursing homes that can be remedied by increased staffing, according to the Biden administration.

Current staffing standards, which were codified in the late 1980s, require homes to have a registered nurse onsite for at least eight consecutive hours, seven days a week and a licensed nurse staff “sufficient” to meet patient care needs.

However, the CMS wants to tie specific hour requirements to the new staffing standards — a move the lawsuit’s plaintiffs say is a “baffling and unexplained departure” from policy.

The suit, filed in U.S. District Court in the Northern District of Texas, argues the new rule doesn’t just clarify requirements for providers — it triples them. 

As a result, the CMS is overreaching its authority and creating “impossible-to-meet standards that will harm thousands of nursing homes,” the plaintiffs argue.

The AHCA and National Center for Assisted Living project that nursing homes will have to hire an additional 102,000 nurses and aides to come into compliance with the rule, at a total cost of $6.5 billion in added expense each year. 

Homes that cannot shoulder such costs may close, which could displace over 290,000 current residents, according to the groups.

“Even by CMS’s low-ball estimate, nursing homes will need to spend more than $40 billion over the next decade to comply with these new staffing requirements,” the lawsuit says. “Congress has never delegated to CMS the authority to impose such onerous and unachievable mandates on practically every nursing home in the country.”

The HHS and the CMS intend to defend the rule, according to a spokesperson for the HHS.

“The status quo in too many nursing homes unacceptably endangers residents and drives workers into other professions,” the spokesperson said.