(Iowa Capital Dispatch) – A group of nonprofit advocacy organizations is seeking to intervene in a lawsuit that challenges new, federally mandated staffing levels in nursing homes. The National Association of Local Long-Term Care Ombudsmen is among seven organizations hoping to ask a federal judge to deny a request made by the nursing home industry and 20 state attorneys general – including Iowa’s Brenna Bird — for an injunction that would block implementation of the new staffing requirements. The organizations have not yet been authorized to file their “friend of the court” brief, but approval in such circumstances is normally granted.

The injunction is being sought in a lawsuit filed eight weeks ago in U.S. District Court for the Northern District of Iowa, and seeks to block implementation of the Biden administration’s new staffing requirements. The lawsuit was filed by Bird and the attorneys general of 19 other states along with 19 industry organizations who argue the new requirements are cost prohibitive and will result in nursing homes closing down.

Joining NALTCO in the fight against the attorneys general are the nonprofit organizations known as the Center for Medicare Advocacy, the National Consumer Voice for Quality Long-Term Care, the Long-Term Care Community Coalition, California Advocates for Nursing Home Reform, Justice in Aging, and the Michigan Elder Justice Initiative. NALTCO’s role in the case is particularly noteworthy in that the organization is comprised of members of each state’s Long Term Care Ombudsman’s Office, which were created by Congress in 1978 to serve as independent advocates for nursing home residents. Typically, each office, including that of Iowa’s Long-Term Care Ombudsman, operates within an arm of their respective state government. The result is that the ombudsmen’s national organization is now opposing the legal efforts of Republican attorneys general in states where many of those ombudsmen now work.

Photo from bettercareplaybook.org.

In October, Bird said she was leading the court challenge of the staffing mandates to ward off a “mass shutdown of nursing homes” and to “stop the Biden-Harris attack on senior care that will force nursing homes out of business.” In November 2023, Iowa Gov. Kim Reynolds publicly announced her opposition to the new staffing rule, joining 14 other Republican governors in signing a letter to President Joe Biden in which they argued the rule was “unrealistic” and would “harm the seniors, elderly and disabled it’s designed to help.”

According to data from the Centers for Medicare and Medicaid Services, 14% of Iowa’s 422 nursing facilities were cited for insufficient staffing in fiscal year 2023, before the new requirements were enacted. That’s more than double the national average, which was 5.9%. Only five other states – Hawaii, Michigan, Montana, New Mexico and Oregon — had a worse record of compliance with the staffing requirements in place at that time.

The Iowa-led lawsuit is one of two currently working their way through the federal court system. The other lawsuit, filed in Texas, was initiated by the American Health Care Association, a lobbying organization that primarily represents for-profit nursing homes. Some observers say the litigation will have little impact on the fate of the staffing mandates since the Trump administration is expected to do away with the requirements once the president-elect take office in January 2025.