On May 23, 2024, the American Health Care Association (AHCA) filed a lawsuit in United States District Court challenging the Federal Minimum Staffing Mandate (the “Mandate”) imposed on the country’s nursing home industry last month by the Centers for Medicare & Medicaid Services (CMS). The lawsuit calls the new minimum staffing requirements “irrational” and “unattainable”, alleging that CMS did not adequately consider the nationwide staffing shortages.
The Mandate being challenged was issued by CMS on April 22, 2024. Among other things, the Mandate replaces the statutory requirement that nursing homes “use the services of [an RN] for at least 8 consecutive hours a day, 7 days a week,” with a new requirement that they “have a registered nurse (RN) onsite 24 hours per day, for 7 days a week that is available to provide direct resident care” (the “24/7 RN requirement”). Additionally, the Mandate abandons the requirement that nursing homes “provide 24-hour licensed nursing services which are sufficient to meet the nursing needs of its residents” and rather imposes the requirement that nursing homes provide a total nurse staffing requirement of a minimum of 3.48 hours per resident day (the “HPRD requirement”).
The lawsuit, which notes that the Mandate “promises to be a nightmare not only for owners and operators of nursing homes, but also for the vulnerable residents they serve”, challenges the Mandate on two grounds:
- CMS did not have the statutory authority to issue the staffing Mandate because Congress never authorized CMS to impose staffing requirements, which “explicitly” and “brazenly” replace the staffing requirements Congress has put into place; and
- The Mandate is arbitrary and capricious by imposing a “one-size-fits-all” requirement on nursing homes that does not account for the varying structures of long term care facilities.
AHCA is asking the Court to vacate and set aside both the 24/7 RN requirement and the HPRD requirement, while also permanently enjoining CMS from taking any action to enforce the Mandate.
If you have any questions on compliance with the mandate or how this lawsuit may affect your facility, please contact the author, the Garfunkel Wild attorney with whom you regularly work, or contact us at [email protected].