Texas Attorney General Ken Paxton has joined the legal fight against the federal government’s new nursing home staffing mandate. The state’s lawsuit, filed Wednesday, aims to overturn a rule that many argue could financially cripple skilled nursing facilities, especially in rural areas.
Legal Grounds: Questioning CMS Authority
The Texas lawsuit, like those before it, challenges the authority of the Centers for Medicare & Medicaid Services (CMS). The mandate requires nursing homes to provide a minimum of 3.48 hours of direct nursing care per resident each day. It also mandates a registered nurse to be on duty 24/7. Texas contends that CMS cannot enforce such a broad regulation without clear congressional approval. The lawsuit cites the Major Questions Doctrine, which argues that federal agencies cannot issue economically significant rules without explicit legislative backing.
Economic Impact: Threat to Rural Healthcare
Attorney General Paxton has voiced concerns about the mandate’s impact on rural healthcare facilities. He warns that the new staffing requirements could force many facilities to close, particularly in underserved areas. “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 stated. The lawsuit argues that the staffing requirements are unrealistic, especially for facilities already struggling with staffing shortages. The fear is that these regulations will worsen healthcare disparities in rural regions.
Judicial Landscape: A Crucial Battle in Texas Courts
The lawsuit has been filed in the US District Court for the Northern District of Texas, Amarillo division. It is expected to be heard by Judge Matthew Kacsmaryk, who is already overseeing a similar lawsuit by the American Health Care Association (AHCA). Appointed by former President Donald Trump, Judge Kacsmaryk has ruled against several Biden administration policies. His decisions in these cases could set a significant precedent for the future of federal regulatory power.
The Stakes: Potential Costs and Consequences
The lawsuits argue that the CMS mandate could lead to high staffing costs and likely force many facilities to reduce services or shut down. The Texas Attorney General’s office estimates that the rule would require Texas institutions to hire over 10,000 additional staff members. These staff members would need specific qualifications, far more than are currently available in the state’s labor market. While CMS estimates the implementation cost at $43 billion over the next decade, the AHCA believes the financial burden could be even greater.
Conclusion: A Rule with Far-Reaching Implications
As this legal battle unfolds, the outcome could significantly impact nursing home operations across the nation. The lawsuits highlight the tension between federal oversight and state autonomy in managing healthcare. The decisions made in this case could reshape the long-term care landscape for years to come. All eyes are on Judge Kacsmaryk as the legal process moves forward.