Rhonda Little is frustrated.
A cook at Cerenity Senior Care nursing home in St. Paul, Little figured that a novel state law would mean a wage hike.
But the Minnesota Department of Human Services was months late in seeking federal approval to pay each nursing home employee at least $19 an hour, with many workers entitled to more based on their nursing license.
“We are understaffed,” Little said at a rally last week staged by Service Employees International Union (SEIU) Healthcare Minnesota and Iowa. “We aren’t being paid enough and we are stressed.”
Sharlene Knutson is also frustrated.
Knutson operates McIntosh Senior Living in the northwestern Minnesota town of McIntosh. She chose to pay her workers based on this potential new state law. But she awaits federal sign off, which would unlock Medicaid money toward paying these salaries.
“How are we supposed to budget when we don’t even know what our freaking rate is?” Knutson said.
Thanks to the wage law, 2026 was set to be a crucial year for nursing homes and their often exhausted and itinerant employees. Instead, nursing facilities are in limbo.
A Minnesota Department of Human Services’ mistake and (possibly) the Trump administration’s jeering attitude toward Minnesota make a previously routine federal approval process anything but.
And as McIntosh Senior Living and other facilities follow a theoretical statute, the lobbying groups for nursing homes filed a lawsuit stating that the three-year-old Minnesota Nursing Home Workforce Standards Board violates federal law.
While industry says this board has too much power, the board’s executive director, Leah Solo, is unsure what power it actually has. Specifically, Solo said she does not know if the board has the ability to compel nursing homes to give workers back pay.
Here is what we do know about the standoff over nursing home worker pay.
Why again does this wage law need Trump administration approval?
The Nursing Home Workforce Standards Board voted for minimum wages to go into effect Jan. 1 of this year.
The board set a wage floor of $19 in 2026, and $20.50 in 2027, with ascending rungs for different occupations. For example, a certified nursing assistant must earn at least $22.50 this year and $24 in 2027.
The wage floor would leverage Medicaid money to help pay these salaries. The federal Centers for Medicare and Medicaid Services would give $18 million, and the state would allot another $18 million.
But federal officials must green light funds used to pay nursing home workers, and they have up to 90 days to review the state’s plan. The minimum wages are set to go into effect 30 days after federal approval.
All that explanation you just read means that if the Tim Walz administration wanted to do all they could to make sure the wage floor went into effect as intended, they would have submitted their request for federal approval at least 120 days before Jan. 1, which was Sept. 3.
Instead, the Department of Human Services, which runs Minnesota Medicaid and so is responsible for such federal petitions, submitted the request Jan. 9 of this year.
DHS officials apologized and said it was an honest mistake. Meanwhile, a DHS spokesperson said they have “not heard any substantive feedback” on their request from federal officials.
A spokesperson from the Centers for Medicare and Medicaid Services declined to provide details on where their review was, stating “CMS does not speculate on potential future actions.”
OK. So, this is just delayed a few months. What’s the big deal?
This is not your father’s Centers for Medicare and Medicaid Services.
Led by Mehmet Oz, CMS is duking it out in court with Minnesota Attorney General Keith Ellison about whether federal officials can claw back $259 million in Medicaid money.
State officials are also prepared to battle with the feds over $2 billion in Congressionally appropriated Medicaid money that Oz threatened to take away.
In other words, while not granting a Medicaid spending request like the one Minnesota is making is rare, CMS has made even more unusual moves the past few months.
“Have you seen the Trump administration with Minnesota? They are not happy,” said Blois Olson, spokesperson for the Long-Term Care Imperative, a group representing nursing home operators.
One might think nursing homes would take pleasure in the Trump administration’s unhappiness, since their lobby vociferously opposed the new wage law.
Related: Minnesota nursing home workers will have to wait for raises because state dropped the ball on paperwork
But it leaves them unable to plan. Operators including Marc Halpert, CEO of Monarch Management, the largest for-profit nursing home chain in Minnesota, say that they are waiting to hear back from the Nursing Home Workforce Standards Board before making any spending decisions.
Other operators like Knutson, who said she is complying with the potential law but is not getting Medicaid assistance to do it, say that they have had to defer other improvements.
“I wanted to fix up my building,” Knutson said. “I wanted to hire another staff person.”
Workers, meanwhile, are seeing their progress slip away.
“We have not received the raises that were mandated for us by Jan. 1, 2026,” said Chasity Blokzyl, a certified nursing assistant at Clara City Senior Living and a member of Service Employees International Union (SEIU). “It has been three months and countless work hours.”
Blokzyl called on the “Standards Board and our employers to make a commitment to back pay now” meaning they would recoup the difference between their pay since Jan. 1 and what it would have been if the law went into effect.
How does this lawsuit affect things?
Let’s just say nursing home operators are cool to the idea of back pay.
Industry trade groups and a staffing agency filed a lawsuit this month saying that the Nursing Home Workforce Standards Act violates federal antitrust and due process laws, among other contentions. The lawsuit calls for no less than dissolution of the Workforce Standards Board.
If this sounds familiar, it is because trade groups previously filed a lawsuit stating that the board’s decree requiring nursing home workers get holiday pay also broke federal law.
U.S. District Judge Laura Provinzino dismissed that case in its preliminary stage, writing that the board’s rule “does nothing more than create a minimum labor standard.”
But the nursing home industry says this lawsuit is different.
Unlike the first complaint, it argues that the board violates constitutional due process “by delegating regulatory power over competitors to self-interested private actors,” Olson said.
Previously: Minnesota has a plan to turn around nursing homes’ staffing crisis. Nursing home operators say it’s a death knell.
Part of the logic here is that while the board is made up of three members representing workers, three members representing industry, and three Walz administration officials, the labor and Walz members vote in lockstep. It means, at least in this administration, that industry is effectively powerless.
Nursing homes also make an antitrust argument, asserting that private market actors, instead of disinterested regulators, are colluding over working conditions.
The result is that the board will “inflict permanent damages” on “the thousands of people who depend on Minnesota’s provider community for care.”
The board declined to comment on the lawsuit.
Rasha Ahmad Sharif, executive vice president for SEIU Healthcare Minnesota and Iowa, said that the union was “not surprised” by the lawsuit. The board’s intention is to compel labor and industry to collaborate, but Sharif said that any such cooperation has been “touch and go.”
What comes next?
According to Rep. Esther Agbaje, DFL-Minneapolis and author of the 2023 Nursing Home Workforce Standards Act, “There isn’t a specific clause in the statute that corresponds to back pay” and that perhaps additional legislation is needed to meet the SEIU’s workers demands.
Any legislative fix is unlikely in a House split between Republicans and the DFL, a sharp departure from the DFL’s 2023 legislative control that birthed the board.
A lawsuit ruling is not imminent. In fact, a lawyer for the nursing home industry asked last week if the judge would not mind a “word count extension of up to 16,500 words applicable to both sides” for written arguments.
Agbaje acknowledged that the board has been at least partly stymied in its mission to improve the toil of nursing home workers.
“The work we did to advance the lives of poor people, give opportunity to those who have been left behind, and uplift the dignity of workers is inevitably reduced to a lawsuit that claims those efforts are unconstitutional,” she emailed.
Related
