A federal judge for the U.S. District Court of Northern Texas on Monday threw out the federal nursing home staffing mandate, while just Thursday the Trump administration defended the staffing rule in a brief filed in the U.S. Court of Appeals for the Eighth Circuit.

Judge Matthew Kacsmaryk of the U.S. District Court for Northern Texas ultimately decided that the mandate wasn’t consistent with Congress’s legislation governing nursing homes. Notably, there was a contrast between the 24/7 registered nurse (RN) rule and Congress’s baseline of having an RN for 8 hours a day, he said.

The mandate requires staffing hours based on number of residents, while Congress mandated consideration of a facility’s individual nursing needs, added Kacsmaryk.

“Though the final rule attempts to remedy chronic nursing home deficiencies, it does so deficiently,” said Kacsmaryk. “The final rule still must be consistent with Congress’s statutes. To allow otherwise permits agencies to amend statutes though they lack legislative power. Separation of powers demands more than praiseworthy intent.”

The Eighth Circuit does not have precedence over the Northern Texas District Court given that Texas falls under the Fifth Circuit, according to the U.S. Court of Appeals. Updates on the mandate follow nursing home industry confidence that the Trump administration would dismiss the rule.

Clif Porter, president and CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), said the Texas ruling is a victory for the nation’s seniors and their families.

“The Court has confirmed that CMS does not have the authority to issue such staffing requirements—only Congress does. Therefore, we now call on Congress to act,” Porter said in a statement. “In light of evolving care practices and our nation’s changing demographics, federal policymakers should not be dictating staffing hours but encouraging innovation and high-quality outcomes. The staffing mandate is a 20th Century solution that should be blocked by Congress once and for all.”

LeadingAge President and CEO Katie Smith Sloan had similar words of celebration.

“The mandate ignored the critical interdependence of funding, care, staffing, and quality, and would have severely impacted our ability to provide the care and services that our nursing home members, along with providers in other care settings such as home health and hospice, deliver every day,” Smith Sloan said in a statement.

Interpreting Trump administration stance

While the industry rejoiced over the Texas ruling, there’s some uncertainty over where exactly the Trump administration stands on this policy.

The brief certainly stands in contrast to the Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr.’s comments during his January confirmation hearings, in which he raised his concerns over the practicality of the staffing rule, calling it a “noble,” yet likely “disaster” for the industry.

That said, newly confirmed Secretary of the Centers for Medicare and Medicaid Services (CMS) Dr. Mehmet Oz hasn’t clearly stated his views on the mandate, but has said a shortage of nurses is the real issue.

And Thursday’s Department of Justice (DOJ) filing urged the appeals court to once again deny a preliminary injunction requested by 20 Republican state attorneys general, two nursing homes and multiple nursing home associations including the American Health Care Association and LeadingAge.

Legal experts for the nursing home sector said this filing may not be so surprising given Trump’s first term.

“Such support seems polar opposite of what we have been seeing with Trump’s agenda of significantly reducing the role of the federal government in several areas and aspects,” Craig Conley, shareholder at law firm Baker Donelson, told Skilled Nursing News. “This is especially true given the costs that the staffing mandate will place in the industry and the additional oversight the mandate will require of CMS.”

The DOJ under former President Joe Biden opposed a first preliminary injunction request in November 2024. When the federal judge in Iowa denied the injunction, industry representatives appealed the case in the Eighth Circuit.

Meanwhile, Trump administration’s DOJ said in its filing that the industry’s lawsuit is “not likely to succeed on the merits,” and that the staffing rule isn’t “arbitrary and capricious.”

Further, CMS made a reasonable determination that staffing requirements were needed, the DOJ said, citing a study commissioned by CMS along with public comments, academic literature, data collected from nursing homes, and listening sessions with residents, staff and others, according to the brief.

From the standpoint of the nursing home sector, the CMS study indicated that no solitary staffing measure could ensure high-quality care.

Regardless, in the April brief, the DOJ also added that the staffing requirements don’t conflict with statutory provision, and “fall comfortably” in CMS’ authority to establish requirements relating to the health and safety of residents.