The Northern Districts of Iowa and Texas are each handling cases challenging recently finalized staffing requirement regulations for long-term care facilities (LTCs).
Dubbed by the state government and trade association plaintiffs as a “one-size-fits-all” approach, the LTC final regulations impose two mandatory staffing requirements: (1) shifting from an 8/7 registered nurse (RN) requirement to a 24/7 RN requirement; and (2) increasing the requirements of RN hours per resident day (HPRD). Additionally, the Final Rule introduces an “enhanced facility assessment” (EFA), a compliance measure requiring LTCs to ensure satisfactory staff and resident involvement. Plaintiffs claim each of these requirements are outside the scope of CMS’s statutory authority and constitute arbitrary and capricious agency action under the Administrative Procedure Act.