Coalition of 20 Attorneys General Challenges New CMS Nursing Home Staffing Rule

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Written By Richard Perdomo

A coalition of 20 state attorneys general has filed a motion for an immediate injunction against a new nursing home staffing rule implemented by the Centers for Medicare & Medicaid Services (CMS). This rule, finalized in May, mandates a registered nurse to be present every hour of every day and requires a total of 3.48 hours of daily nursing care for each resident. The plaintiffs argue that CMS has overstepped its authority, citing a significant increase in the financial burden on nursing homes—estimated compliance costs reaching $43 billion.

LeadingAge officials provided legal declarations to demonstrate the rule’s adverse impact on nursing facilities. For instance, the Halstad Living Center in Minnesota incurred over $10,000 in administrative costs just for initial compliance efforts, far exceeding CMS’s cost estimates. Providers express concerns about vague compliance definitions leading to penalties despite good faith efforts.

The attorneys general emphasize the potential for irreparable harm, arguing that costs incurred in preparation for the rule cannot be recouped if the court rules against CMS. They assert that the financial and administrative burdens may force many nursing homes to close or reduce services, particularly in rural areas where staffing is already a challenge. The plaintiffs seek a nationwide injunction to prevent an uneven competitive landscape among nursing homes.

 

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