A federal judge has struck down a key component of the Biden administration’s plan to improve staffing at nursing homes, ruling that the proposed mandate was inconsistent with existing federal law.
The rule, which sought to ensure better care for nursing home residents by requiring more staff, was vacated on Monday by U.S. District Court Judge Matthew Kacsmaryk in Texas.
The mandate, introduced last April, aimed to address longstanding concerns about understaffing in nursing homes by setting the first-ever federal minimum staffing levels.
It would have required facilities to hire more registered nurses and nurse aides over the next few years, at an estimated cost of $6.8 billion annually. Critics, including nursing home operators and their trade associations, argued that the staffing requirement was unrealistic and could lead to widespread closures.
In his ruling, Judge Kacsmaryk acknowledged that staffing issues in nursing homes are a serious concern but said the rule failed to align with Congress’s legislative framework for nursing home operations.
“Though rooted in laudable goals, the Final Rule still must be consistent with Congress’s statutes,” Kacsmaryk wrote.
The decision is a setback for the Biden administration, which had championed the rule as a critical step toward improving the quality of care in nursing homes.
The rule had called for nursing homes that receive Medicare and Medicaid funding to provide at least 3.48 hours of nursing care per resident per day and ensure a registered nurse is on-site at all times.
The mandate was to be phased in over three years, with additional time granted to rural areas.
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Opponents, including the American Health Care Association and LeadingAge, argued that the staffing mandate was too burdensome for facilities already struggling to recruit and retain workers.
They emphasized that the rule lacked provisions for workforce training and recruitment support, and would ultimately harm vulnerable seniors.
The Biden administration’s Department of Health and Human Services (HHS), which finalized the rule, has yet to respond to the ruling. The decision is likely to spark further debate about how best to address the staffing crisis in long-term care facilities.
