The contentious Nursing Home Minimum Staffing Rule (Rule), which established minimum staffing requirements for federally funded long-term care facilities (LTC) such as skilled nursing facilities (SNFs) for Medicare and nursing facilities (NFs) for Medicaid, was recently gutted by the United States District Court for the Northern District of Texas. The Rule, which had been finalized and went into effect in June 2024, raised concerns as many facilities found the staffing requirements unattainable due to practical and financial challenges.
The nationwide injunction came after the Rule was challenged by the American Health Care Association and the Texas Attorney General. The court vacated the 24/7 requirement and other minimum staffing standards under the Rule holding that they “flout” the Administrative Procedure Act. In its ruling, the court relied on the United States Supreme Court Decision in Loper Bright that eliminated the Chevron Deference. Specifically, the court held that Congress had already specified that nurses in LTCs should be present 8 hours per day and, therefore, a regulatory agency such as the Centers for Medicare & Medicaid Services (CMS) does not have the authority to impose a stricter standard. The opinion can be found here.