Iowa district court vacates CMS minimum nurse staffing requirements

The U.S. District Court for the Northern District of Iowa June 18 vacated components of the Centers for Medicare & Medicaid Services’ minimum nurse staffing rule requiring nursing homes to have a registered nurse onsite 24/7 and prescribing a minimum total nurse staffing hours per resident day. The court kept in place the rule’s enhanced facility assessment and Medicaid reporting requirements.

“CMS’s general rulemaking power to promulgate ‘such other requirements as the Secretary deems necessary’ does not constitute clear authorization to mandate rigid staffing requirements for [long-term care] facilities,” wrote District Court Judge Leonard T. Strand in the ruling. “Therefore, I find that CMS did not have authority to promulgate the 24/7 RN requirement and the HPRD requirements pursuant to its health and safety rulemaking authority.”

A district court in Texas also vacated the minimum staffing mandate in April. The AHA has opposed the staffing mandate, saying in a friend-of-the-court brief in October 2024 that it “is not just an overly simplistic and costly solution to the nursing shortage; it is no solution at all.”