A federal judge has rejected a request to temporarily stop the implementation of the federal nursing home staffing mandate in a much-awaited ruling issued Thursday.

Judge Leonard T. Strand of the U.S. District Court for Northern Iowa found that the preliminary injunction – sought by 20 states, 17 LeadingAge affiliates and two Kansas nursing home facilities – fell short on nearly all grounds.

“With regard to nearly every aspect of the Final Rule, the plaintiffs have failed to demonstrate that a preliminary injunction is necessary in order to preserve the status quo and prevent irreparable harm during the pendency of these proceedings,” he said, adding, “The only potential exception involves the Final Rule’s [enhanced facility assessment] requirement.”

In seeking injunctive relief, the states had argued in December that nursing homes would be able to pause activities that were currently leading to higher costs and other burdens as a result of the pending staffing mandate. Enhanced facility assessments required by the staffing rule – and implemented in August – have led to increased costs, the plaintiffs said.

Upon hearing the government’s arguments earlier, Judge Strand questioned whether federal officials had the authority to increase the number of hours to 24/7 by registered nurses (RNs) as mandated by the Centers for Medicare and Medicaid Services’ (CMS) staffing rule, stating it meant overstepping congressional authority.

However, in issuing Thursday’s ruling, Judge Strand said justice would be better served by promptly moving to the stage of deciding motions in this case, noting that the plaintiffs have raised substantial issues and concerns about the 24/7 requirement for RNs as well as the minimum hours per patient day.

“[T]he interests of justice will be best served by proceeding quickly to the dispositive motions stage of this case, thus allowing the parties to address the merits directly, rather than through the lens of a motion for a preliminary injunction,” he said.

Any dispositive motions must be filed on or before March 3, resistances by April 3, and the reply materials by April 24.

If the staffing mandate survives both legislative and legal challenges, along with the incoming Trump Administration’s widely anticipated rejection of it, there is still some time before it is implemented.

The federal staffing rule for nursing homes stipulates that facilities must meet individual minimum staffing standards, including 0.55 HPRD for RNs and 2.45 HPRD for certified nurse aides (CNAs), within three years for urban facilities and five years for rural facilities after the publication of the final rule.

In response to the ruling, the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL) said in an emailed statement shared with Skilled Nursing News that while it was disappointed in the ruling on the preliminary judgement, the ruling would not impact the validity or substance of AHCA’s lawsuit against the staffing mandate.

“It’s unfortunate but not surprising that a request for a preliminary injunction was denied. This ruling has no bearing on the merits or strength of AHCA v. Becerra,” the statement read. “The real question before the courts is whether HHS and CMS have the authority to issue this unrealistic and unfounded staffing mandate, and the answer is a resounding no. Congress has claimed the ability to set specific staffing standards. We will continue to make that argument in the Northern District of Texas and are confident we will be successful.”