Twenty Republican state attorneys general have filed a lawsuit against the Biden administration over a new federal rule regarding minimum staffing requirements for nursing homes, claiming it will force many facilities out of business. The lawsuit, led by Iowa Attorney General Brenna Bird, Kansas Attorney General Kris Kobach, and South Carolina Attorney General Alan Wilson, was filed on Tuesday in federal court in Cedar Rapids, Iowa.
Other plaintiffs include attorneys general from Georgia, Florida, and Virginia, as well as state affiliates of LeadingAge, a network of nursing home industry groups in states such as Iowa, Maryland, and Minnesota.
The rule, announced in April by the U.S. Department of Health and Human Services (HHS), mandates that nursing homes must have a registered nurse on duty 24 hours a day and total nurse staffing of at least 3.5 hours per resident per day. Previously, federal law required nursing homes to employ a registered nurse for only eight consecutive hours each day.
The plaintiffs argued in their complaint that this new rule poses an “existential threat” to the nursing home industry, asserting that many already-struggling facilities will have no option but to shut down. “And the main victims will be the patients who will have nowhere else to go,” they stated.
They also claimed that HHS acted arbitrarily and capriciously by implementing the rule without sufficiently considering the nationwide nursing staff shortages. HHS did not respond immediately to requests for comment.
The rule applies to nursing homes participating in the federally funded Medicare and Medicaid programs, which constitute a significant majority of nursing homes across the country. The implementation of the rule is set to occur over several years.
President Joe Biden’s administration initially proposed these rules last September, committing to hold nursing homes accountable for patient safety in light of the abuse and neglect highlighted during the COVID-19 pandemic. Texas Attorney General Ken Paxton had previously brought a similar lawsuit in August.
At least one multistate nursing home operator, LaVie Care Centers, has attributed its bankruptcy filing to the new staffing rule.
The case is titled State of Kansas et al v. Becerra et al, U.S. District Court for the Northern District of Iowa, No. 1:24-cv-00110.
