Texas Attorney General Ken Paxton sued the Biden administration Wednesday seeking to block a rule that requires nursing homes to have a minimum level of nurse and aide staffing to care for patients.
The lawsuit argues the Centers for Medicare and Medicaid Services does not have the authority to require more staffing in nursing homes. Paxton also argues the rule violates the major questions doctrine, a legal theory that states that agencies cannot issue regulations carrying significant economic consequences without clear direction from Congress.
The lawsuit argues the extra costs of hiring more staff will force many nursing homes in Texas “out of business.”
“This power grab by Biden’s health bureaucrats could put much-needed care facilities out of business in some of the most underserved areas of our state,” Paxton said in a statement.
The lawsuit was filed in the Amarillo division of U.S. District Court of the Northern District of Texas, all but assuring the case will go to Judge Matthew Kacsmaryk. Kacsmaryk was appointed by former President Donald Trump and has ruled against several Biden administration policies.
The American Health Care Association, which represents nursing homes, filed a lawsuit over the rule in May in the same court. The case is pending.
The rule, finalized in April, would require nursing homes paid by Medicare to provide at least 3.48 hours of nursing care per resident per day and have a registered nurse on duty 24 hours a day, seven days a week.
Under current law, federal laws are vague. Nursing homes paid by Medicare and Medicaid must provide “sufficient” staffing levels on a 24-hour basis that ensures the well-being of residents. They must also have a registered nurse on duty eight hours per day.
CMS estimates the requirements will cost long-term care facilities $43 billion over a 10-year period, without accounting for exemptions for facilities that qualify. The Biden administration has argued nursing homes are routinely understaffed, leading to neglect and worse health outcomes for residents.
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