The Department of Health and Human Services filed more than 75,000 pages of rule-making records with a federal court Sept. 13, beginning a formal defense of its controversial nursing home staffing mandate.

The submission of the administrative record is the first significant advance in the case since the American Health Care Association brought its challenge to the minimum staffing standard in late May. The Texas Health Care Association, three Texas providers and LeadingAge are also part of the case.

In another development at press time, District Court for the Northern District of Texas Judge Matthew
Kacsmaryk was considering whether to fold in a separate federal challenge of the staffing mandate.

Texas Attorney General Ken Paxton has sued to get the court to vacate the rule. In a Sept. 10 filing, Paxton noted the two cases “share common questions of law or fact, consist of similar parties, the same claims, and [have] the same relief sought.”

In AHCA v. Becerra, HHS had to justify the mandate by sharing the materials it used in the rule-making process. The documents, which include 46,000-plus public comments on the proposed rule, were submitted electronically and not immediately available for review.