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The activities director of a nursing home stands and holds the hand of a resident in a wheelchair while another staff member holds the hand of a resident, also in a wheelchair, on the right. Two other residents in wheelchairs sit in the same circle — politics coverage from STAT — Jeff Chiu/AP

A new federal lawsuit challenging the Biden administration’s new minimum nursing home staffing rule lays out the worst-case scenario: Hundreds of long-term care facilities forced to downsize or close, tens of thousands of vulnerable seniors displaced, and countless others waiting longer for care.

Not only that, the complaint argues that the Centers for Medicare and Medicaid Services lacked the authority to implement the final rule. The lawsuit was filed on Thursday by the American Health Care Association, a Washington, D.C.-based trade group of more than 14,000 nursing homes, along with its Texas counterpart and three Texas nursing homes.

“The Final Rule thus promises to be a nightmare not only for owners and operators of nursing homes, but also for the vulnerable residents they serve, in direct derogation of CMS’s statutory mandate,” according to the complaint, filed in the Northern District of Texas. In addition to CMS, it lists the department of Health and Human Services and secretary Xavier Becerra as defendants.

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