On April 11, 2025, we published an alert, Federal Judge Vacates Key Provisions of CMS’s Nursing Home Staffing Mandate, after the U.S. District Court for the Northern District of Texas vacated two key provisions of the Centers for Medicare & Medicaid Services’ 2024 Final Rule containing the nationwide staffing mandate. (American Health Care Association, et al., v. Robert F. Kennedy, Jr., et al., Case No: 2:24-cv-00114-Z-BR). In that ruling, Judge Kacsmaryk found that CMS acted outside its authority and vacated the requirements that skilled nursing facilities have a registered nurse on-site 24/7 and the onerous federal minimum staffing ratios. In our previous alert, we noted that CMS had the opportunity to appeal this ruling.

On June 6, 2025, CMS filed its appeal, and the matter will now proceed to the 5th Circuit for review. Concurrently, within the federal budget reconciliation bill (the “One Big Beautiful Bill Act”) introduced on May 20, 2025, the legislature proposed a 10-year moratorium on enacting the staffing mandates under the Final Rule. We will continue to watch the status of this legislation as the bill proceeds through the Senate.