SCOTUS, in a 7-2 opinion, held that private persons can sue public nursing homes under 42 U.S.C. §1983 for violations of patient rights set forth in the Federal Nursing Home Amendments Act of 1987 (FNHRA). Justices Thomas and Alito dissented. See Health and Hospital Corporation of Marion County, Indiana v. Talevski (No. 21-806, June 8, 2023).
SCOTUS affirmed the holding of the Seventh Circuit, which previously concluded that the FNHRA rights relied upon by Gorgi Talevski — the right to be free from unnecessary chemical restraints and to be discharged or transferred only when certain preconditions are met — and the violation thereof could be brought in federal court via 42 U.S.C. §1983.
The Talevski ruling is important for preserving the rights of nursing home residents who are entrusted to the care of government-run nursing homes and their family members who often feel their concerns about the treatment of their loved ones are ignored or dismissed. This ruling now clarifies that they may turn to 42 U.S.C. §1983 to enforce their rights to be free from unnecessary physical or chemical restraints and to be discharged or transferred only when certain requirements are satisfied.
In the Talevski case, Mr. Talevski was a nursing home resident. His wife filed a lawsuit against his county-run nursing home for violating his FNHRA rights. She alleged that the nursing home unnecessarily medicated him, transferred him on multiple occasions to other facilities without following certain procedures, and ultimately improperly refused to re-admit him. Mrs. Talevski claimed these were violations of his FNHRA rights and that she could enforce these rights on his behalf under 42 U.S.C. §1983. This statute allows any person deprived of any rights provided by the Constitution or other U.S. laws to file a private right of action in federal court to enforce these rights. Health and Hospital Corporation (HHC) argued this was not permissible. The Seventh Circuit ruled in favor of Talevski, and HHC filed a petition for certiorari, which was granted by SCOTUS.
SCOTUS rejected HHC’s arguments that §1983 only applies to some laws and not others (i.e., that it excludes enforcing rights recognized by the FNHRA) and that there should be a carveout for laws Congress enacts via the Spending Clause, as argued by HHC. It concluded that the FNHRA provisions regarding chemical restraints and conditions required to discharge or transfer a patient are §1983 enforceable rights and not incompatible with any statutory scheme Congress created for the protection of these rights.
SCOTUS first concluded that FNHRA actually secured rights for §1983 purposes. The fact that Congress created the FNHRA through its authority in the spending clause of the Constitution did not change this. The sections of FNHRA relied upon by Mr. Talevski unambiguously confer individual federal rights enforceable under §1983.
HHC could have defeated this presumption by showing that Congress did not intend that §1983 be available to enforce those rights. However, it did not make this showing.
There is no evidence within FNHRA that Congress meant to preclude private enforcement of these rights. Furthermore, the two aforementioned sections of FNHRA meet the “unambiguous conferral” test established in prior case law, meaning Congress has “unambiguously conferred” “individual rights within the statute upon a class of beneficiaries” to which the plaintiff belongs. FNHRA does so via its unnecessary restraint and pre-discharge notice provisions.
Finally, HHC did not show that enforcement of these rights via §1983 would thwart the operation of any administrative remedial scheme within FNHRA. SCOTUS concluded that to hold otherwise would require it to rewrite the sections of FNHRA upon which Talevski relied, which it declined to do.
Read the full text of the decision here.
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