The Centers for Medicare & Medicaid Services (CMS) on Friday filed a 75,000-page administrative record for its defense of the nursing home staffing mandate.

It’s the first movement from CMS since the American Health Care Association (AHCA) filed a lawsuit challenging the mandate in May. The 75,000 pages were shared via a file-sharing device between parties and was not made available electronically due to its size.

“CMS is committed to promoting safety and quality of care in the nation’s nursing homes. The agency does not comment on matters subject to litigation,” a CMS spokesperson told Skilled Nursing News, when asked for the 75,000-page file and statement on the defense filing.

Meanwhile, the state of Texas sought and was approved for consolidation of its own lawsuit against the staffing mandate with what was filed by AHCA, LeadingAge and other stakeholders in the industry – the state filed its lawsuit on Aug. 14, about three months after AHCA.

AHCA and several Texas-based operators formally filed a joint motion for briefing schedule on Aug. 9, which could result in a resolution on the lawsuit to be reached as early as January. The defendants, including CMS, the Department of Health & Human Services (HHS), CMS Administrator Chiquita Brooks-LaSure and HHS Secretary Xavier Becerra, agreed at the time that the case might be resolved by cross-motions for dispositive relief.

Dispositive relief is a request for a court to rule in a party’s favor, and can result in the dismissal or settlement of a case. This scenario would avoid costly litigation, Legal experts told Skilled Nursing News. As part of the schedule, CMS was tasked with filing their administrative record by Sept. 13, which they did.

AHCA and other plaintiffs must challenge the adequacy of the administrative record by Sept. 27. On top of potential dispositive relief, a Supreme Court decision in June may significantly weaken federal agencies’ authority to regulate industries. It further opens the door for AHCA to challenge the staffing rule, among other possible challenges to CMS authority.

Texas originally brought claims alleging CMS violated the Administrative Procedure Act (APA) by creating a rule that is in excess of statutory jurisdiction of authority, and is arbitrary and capricious.

If actions before the court involve a common question of law or fact, the court can consolidate the actions, or join for hearing or trial any or all matters at issue, the state said in its filing. The court could also issue any other orders to avoid unnecessary cost or delay for the cases, they said.

“Consolidation would therefore ensure both cases are handled expeditiously and ‘eliminate unnecessary repetition and confusion’ between potentially dueling dispositions. Permitting Texas to join this other recently-filed case and streamline the briefing favors consolidation,” the state said in its argument.

Texas operators would need to hire more than 10,000 new staff or face closure if they’re unable to meet minimum staffing requirements. The mandate would cause a “major healthcare crisis in Texas,” the state said, with more rural nursing homes shutting down as an “inevitable result.”

The state expects decreased access due to consolidation in urban areas as well.

CMS’ minimum staffing rule finalized on April 22 is already unfolding, with assessments required for providers receiving Medicare and Medicaid funding. A minimum of 3.48 hours per resident per day (HPRD) is mandated in the rule, along with 24/7 registered nurse (RN) coverage.

If implementation continues, urban operators will need to meet federal minimums by May 2026, and rural operators have until May 2027.