The Biden administration argues that hiring more staff can address long-standing quality of care issues at nursing homes.

Currently, homes must have a registered nurse on duty for at least eight hours per day, seven days a week. They need enough licensed nurses to meet the patients' needs, as stated in the staffing standards from the late 1980s.

The plaintiffs argue that this is a surprising and unexplained change in policy because the CMS plans to connect specific hour requirements to the new staffing standards. The lawsuit argues that the new rule increases the requirements for providers threefold instead of simply clarifying them, and it files the claim with the U.S. District Court for the Northern District of Texas. 

Plaintiffs argue that, as a result, the CMS is imposing unrealistic standards that will negatively impact thousands of nursing homes. Nursing facilities will have to hire 102,000 more nurses and assistants to comply with the regulation. This will cost an extra $6.5 billion per year. Over 290,000 current residents may have to move if their homes are closed because they can't afford the expenses.

The lawsuit claims that nursing facilities would need to spend over $40 billion in the next ten years to meet the increased staffing standards, even with the lowest estimate from CMS. Congress has never authorized CMS to impose such burdensome and impractical requirements on nearly all nursing homes nationwide.

According to an HHS spokesperson, the CMS and the HHS plan to defend the rule.