Q: Will the recent Supreme Court decision that courts do not need to follow the government’s interpretation of regulations have an impact on the nursing home staffing mandate?
A: Yes, I believe that the recent US Supreme Court decision in Loper Bright Enterprises v. Raimondo represents a profound shift to the courts and away from federal agencies when it comes to regulatory interpretation. That shift will significantly impact the entire federal regulatory framework to which the long-term care industry is subject, including the Centers for Medicare & Medicaid Services’s ill-conceived staffing mandate.
The mandate is being challenged via a pending lawsuit in US District Court for the Northern District of Texas. The case, filed by the American Health Care Association and other interested groups, alleges that CMS grossly overstepped its authority by implementing a rule that mandates “irrational and unattainable” staffing levels that would require increased staffing in more than 80% of nursing home nationwide, even though CMS acknowledged that most nursing homes are already providing more than adequate care.
Prior to Loper, issues raised in the lawsuit would have been examined by the court using a standard that gave a great deal of deference to the agency’s decision, so long as the agency’s interpretation was reasonable. Now, because of Loper, the court need not give any deference to CMS interpretation of Medicare and Medicaid statutes from which it claims authority to enact the mandate.
The revised standard should significantly ease the burden on the plaintiffs. Frankly, I believe we are not yet aware of all of the potential consequences and outcomes associated with Loper. However, I believe it will be very helpful in preventing or limiting the harmful effects of this regrettable foray by CMS.
Please send your legal questions to Norris Cunningham at [email protected].
From the September 2024 Issue of McKnight's Long-Term Care News