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Lawsuit: Nursing Home Residents the ‘Main Victims’ of Federal Staffing Mandate
- Iowa Attorney General Brenna Bird and 19 other attorneys general filed a lawsuit earlier this month against the federal nursing home staffing mandate.
- The suit alleges that nursing home residents are the “main victims” of the staffing standards.
- The Centers for Medicare and Medicaid Services announced a final ruling on staffing standards in April that many facility leaders believe will negatively impact the nursing home industry.
Kari Williams
Nursing CE Central
Yet another lawsuit has been filed against the federally mandated nursing home staffing rule — this time arguing that nursing home residents are the “main victims” of the staffing standards.
Iowa Attorney General Brenna Bird filed the suit on Oct. 9, along with19 other states.
“Our seniors spend a lifetime investing in our communities,” Bird said in announcing the lawsuit. “Now, we need to invest in them by ensuring they have access to the care they need. I am suing to stop the [White House] attack on senior care that will force nursing homes out of business, increase costs for families, and remove access to senior care altogether.”
Remind Me of the Requirements
The Centers for Medicare and Medicaid Services (CMS) issued a final ruling in late April, solidifying a nursing home staffing mandate.
The Minimum Staffing Standards for Long-Term Care Facilities ruling, finalized in April, requires all nursing homes that receive federal funding through Medicare and Medicaid maintain staffing ratios of 3.48 hours per resident per day of total staffing.
Facilities have three or five years to implement the staffing standards, depending on whether they are in a rural or urban area.
Funding was not included in the ruling, but a staffing campaign is expected to include more than $75 million to help states with recruitment.
What’s in the New Lawsuit?
The latest lawsuit, filed in the U.S. District Court for the Northern District of Iowa, Cedar Rapids Division, makes many of the same arguments as previous lawsuits, alleging that the mandate is an “existential threat” to the nursing home industry:
- A study found that more than 100,000 full-time staff would need to be hired to meet the staffing requirements laid out in the mandate.
- The ruling is expected to cost roughly $6.8 billion annually.
- Nearly all “current skilled nursing facilities” would not comply with at least one of the requirements.
- One-fourth of nursing home residents will be “at risk of losing necessary care” if facilities can’t meet the mandate.
The Iowa-led suit also argues that the mandate is unlawful and puts a “monumental financial burden” on long-term care facilities.
LeadingAge South Carolina’s president and CEO Kassie South, said there’s “just a numbers problems.” The organization is among the plaintiffs in the most recent lawsuit.
“We don’t have enough people to be able to fill this mandate,” South told the (South Carolina) Post and Courier, “which will close — and already has shut down — services within our state.”
Other Lawsuits That Could Affect Nursing Home Residents
The American Health Care Association filed its lawsuit in May, arguing that HHS and CMS violated the Administrative Procedures Act. Last month, Texas Attorney General Ken Paxton filed suit, alleging the CMS ruling violates the Major Questions Doctrine and is a “power grab.”
After CMS announced its final ruling on the matter, the American Nurses Assocation issued a statement in support.
“We are so pleased to see this rule be issued and are especially glad that the agency included ANA’s recommendations to ensure nurse input is included in facility assessments,” said ANA Chief Nursing Officer Debbie Hatmaker, PhD, RN, FAAN. “Without taking the voice of nurses in LTC facilities into account, it is impossible to improve their place of work in a meaningful way.”
The Bottom Line
The Iowa attorney general took the lead on the latest legal battle for the federally mandated nursing home staffing mandate. Nineteen other states co-signed the lawsuit, making similar arguments to two lawsuits that have already been filed against the mandate.
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