Texas Attorney General Ken Paxton has filed a lawsuit against the Biden administration to block a new federal rule mandating increased staffing levels in nursing homes, which he argues could force many facilities, especially in rural areas, out of business. The rule, issued by the Centers for Medicare & Medicaid Services, requires nursing homes to provide at least 3.48 hours of nursing care per resident per day and to have a registered nurse on duty 24/7. Paxton claims that the agency lacks the authority to impose such regulations without explicit congressional approval, referencing the Major Questions Doctrine. The lawsuit was filed in the Northern District of Texas, where Judge Matthew Kacsmaryk, known for ruling against several Biden policies, will preside. The American Health Care Association has also filed a lawsuit regarding the same rule, which is projected to cost long-term care facilities $43 billion over the next decade. The Biden administration introduced the rule in response to concerns over patient safety highlighted during the COVID-19 pandemic.