Regulatory Revolution: Supreme Court Abandons Chevron Doctrine and Its Impact on Nursing Home Regulations

Thirty-some years ago, when I was in law school, Chevron was relatively new, and it quickly became a cornerstone of administrative law. Many of my legal cases have since pivoted around this doctrine. Now, with the Supreme Court’s recent decision in Loper Bright Enterprises vs. Raimondo to abandon Chevron, I find myself needing to learn all over again. This landmark ruling has profound implications for the healthcare sector, particularly nursing home regulations.

The Loper Bright decision marks a significant shift in administrative law by curtailing the Chevron doctrine, which previously granted deference to federal agencies in interpreting ambiguous statutes. This landmark ruling has profound implications for the healthcare sector, particularly nursing home regulations.

The Chevron Doctrine

Chevron deference allowed agencies like the Centers for Medicare & Medicaid Services (CMS) to interpret laws and implement regulations with minimal judicial interference. However, the Supreme Court’s decision to overturn this doctrine means that courts will now have greater authority to scrutinize and potentially overturn agency rules.

Impact on Nursing Home Staffing Mandate

One immediate area of interest is the CMS’s proposed staffing mandate for nursing homes. The American Health Care Association (AHCA) and Texas Health Care Association have already filed a lawsuit challenging this rule, arguing that it exceeds CMS’s statutory authority and imposes unfeasible standards on nursing facilities. With the Chevron deference no longer in place, courts are more likely to entertain these arguments, potentially leading to the nullification of the staffing mandate.

Survey and Certification, Conditions of Participation, and Civil Monetary Penalties

Beyond staffing, the ruling could also affect CMS’s authority in other regulatory areas:


      • Survey and Certification: The CMS’s processes for certifying and surveying nursing homes may face increased legal challenges, potentially leading to inconsistencies in enforcement.

      • Conditions of Participation: Requirements that nursing homes must meet to participate in Medicare and Medicaid programs could be subject to greater judicial review, impacting their implementation.

      • Civil Monetary Penalties: The enforcement of penalties for non-compliance may become more contentious, with facilities potentially more likely to contest fines and other sanctions.

    The Federal Court Case

    The AHCA’s lawsuit, filed in the Northern District of Texas, argues that the staffing mandate is “arbitrary and capricious” and violates the Administrative Procedure Act. The plaintiffs claim that the rule places undue burdens on nursing homes, potentially exacerbating staffing shortages and financial strains. The Supreme Court’s ruling may embolden such legal challenges, leading to increased litigation and potential rollbacks of regulatory mandates.

    Preparing for Changes

    Nursing homes should take proactive steps to prepare for potential regulatory changes:


      1. Stay Informed: Monitor ongoing legal developments and rulings that could affect current and future regulations.
      2. Legal Readiness: Consult with legal experts to understand the implications of changes and develop strategies to comply with evolving regulations.
      3. Advocacy and Engagement: Engage with industry associations and advocacy groups to stay updated on policy changes and participate in lobbying efforts.
      4. Operational Adjustments: Review and adjust operational practices to ensure compliance with existing regulations while being prepared for potential changes.


      The Loper Bright Enterprises vs. Raimondo decision heralds a new era of judicial scrutiny over federal regulations. For the nursing home industry, this means that critical areas such as staffing mandates, certification processes, conditions of participation, and enforcement of civil penalties will face heightened legal challenges. Stakeholders must stay informed and engaged to navigate this evolving regulatory environment.

      Our firm will be closely monitoring and reporting on these developments to provide timely updates and guidance. Old dog. New tricks.