Texas AG sues Biden administration over nursing home staffing rule

AUSTIN (KXAN) — The Texas attorney general is suing the federal government to stop a rule requiring minimum staffing standards in nursing homes nationwide.

The rule, proposed last year by the U.S. Department of Health and Human Services (HHS) and finalized earlier this year by the White House , requires any skilled nursing facility that receives funding from the federal government to offer a certain number of hours of care to each resident every day. It also requires these facilities to staff a registered nurse on-site at all times.

According to the lawsuit filed Wednesday, Attorney General Ken Paxton claims the staffing rule violates the major questions doctrine — in which the Supreme Court held that in cases where a government agency is seeking to act on or decide an issue of major national significance, the action must be supported by clear congressional authorization.

The filing alleges the rule exceeds the authority of the Centers for Medicare & Medicaid Services (CMS), in addition to “inflicting enormous costs, requiring the hiring of tens of thousands of registered nurses and nurse aids who do not exist, and shutting down many long-term care facilities,” it reads in part.

“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 said. “We are taking the federal government to court over this rule that could worsen rural care shortages by shutting down facilities due to new hiring quotas that are impossible to fill.”

The concerns echo those made by a coalition of U.S. lawmakers earlier this year , after they filed legislation aimed at blocking the staffing rule.

However, other lawmakers, such as Texas Rep. Lloyd Doggett , have supported the rule and even pushed for it to be stronger. Advocates for aging people, such as AARP, called the rule “long overdue.”

“Far too many residents and families have experienced tragic consequences because of poorly staffed facilities,” said Nancy LeaMond, executive vice president and chief advocacy and engagement officer for AARP.

When the rule was proposed, HHS Secretary Xavier Becerra said the goal was to offer safe, high-quality care to anyone living in one of these facilities.

“When facilities are understaffed, residents suffer. They might be unable to use the bathroom, shower, maintain hygiene, change clothes, get out of bed, or have someone respond to their call for assistance. Comprehensive staffing reforms can improve working conditions, leading to higher wages and better retention for this dedicated workforce,” Becerra said.

Paxton’s filing argues that CMS relied on a “flawed study” to create the rule, did not clearly articulate why minimum staffing standards are needed and did not take into account the “massive” staffing shortage that will make compliance with the rule difficult, if not “a practical impossibility.”

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