On June 8, 2023, the U.S. Supreme Court held that private individuals may sue publicly owned nursing homes for violations of the Federal Nursing Home Reform Act of 1987 (FNHRA). Plaintiff Gorgi Talevski and his wife brought a lawsuit against a county-owned nursing home and its agents, Health and Hospital Corporation of Marion County (HHC), claiming that HHC’s treatment of Mr. Talevski violated his rights guaranteed under the FNHRA. Mr. Talevski sought damages against HHC for the violation of his FNHRA rights pursuant to the Civil Rights Act of 1971, codified at 42 U.S.C. § 1983 (Section 1983). The Supreme Court held, in a 7-2 opinion, that individuals may privately enforce the provisions of FNHRA and seek damages from state-owned nursing homes pursuant to Section 1983.
At issue in Health & Hospital Corporation of Marion County v. Talevski, was the question of whether there was a “private right of action” whereby private individuals may sue state-owned nursing homes for damages if the nursing homes violate the health, safety, and dignity rights protected by FNHRA. FNHRA ensures that nursing homes that receive Medicaid funding respect and protect their residents’ rights to be free from, among other things, unnecessary physical or chemical restraints, and to be discharged or transferred only when certain preconditions are satisfied. Mr. Talevski was a resident at a nursing home owned by HHC, a county-owned entity that received Medicaid funding. He and his wife alleged that HHC improperly and unnecessarily restrained Mr. Talevski through the use of chemical restraints, namely by giving him six strong psychotropic medications that allegedly caused him to be unable to feed himself and unable to communicate in English. Mr. Talevski and his wife further alleged that HHC violated his FNRHA-protected rights by forcibly transferring him to an in-patient psychiatric facility on multiple occasions without providing him or his family notice of the transfers.
Although FNHRA has its own enforcement mechanisms, including state and federal oversight of Medicaid-participating nursing homes, Section 1983 of the Civil Rights Act of 1871 permits any person within the jurisdiction of the United States to sue any other person or entity acting “under color of” state law if that other person or entity has deprived them of “any rights, privileges, or immunities secured by the Constitution and laws” of the United States. Mr. Talevski and his wife argued that Section 1983 permitted them to sue HHC, a county-owned nursing home acting “under color of” state law, for depriving Mr. Talevski of his rights secured by FNHRA, a law of the United States. HHC argued that Section 1983 contains an implicit carveout for laws that Congress enacts via its Spending Power—meaning that Section 1983 could not be used to enforce any rights guaranteed by FNHRA. HHC contended that state and federal oversight of Medicaid-participating nursing homes is sufficient to enforce FNHRA because the government can sanction and even terminate funding if it finds nursing homes violate FNHRA. HHC further argued that, even if Section 1983 applied to laws enacted pursuant to the Spending Power, FNHRA does not create rights that nursing home residents can enforce via Section 1983.
The Supreme Court rejected all of HHC’s arguments. First, it rejected HHC’s argument that Section 1983 does not create enforceable rights for laws passed by Congress pursuant to its Spending Power, finding that the plain language of Section 1983 can broadly apply to all federal laws, not just laws that do not rest on the Spending Power.
Second, the Supreme Court held that Section 1983 can presumptively be used to enforce “unambiguously conferred federal individual rights,” unless a private right of action under Section 1983 would thwart any enforcement mechanism that the statute already contains for protection of the rights it created. The Supreme Court held that the two FNHRA provisions at issue here—the right to be free from unnecessary physical or chemical restrains and the right to be discharged or transferred from a nursing home only when certain preconditions are satisfied—unambiguously create rights enforceable by Section 1983. The Court further held that there is no incompatibility between private enforcement under Section 1983 and FNHRA’s separate enforcement mechanism.
Accordingly, the Supreme Court held that Mr. Talevski’s case can proceed in court, and he and his wife are permitted to sue HHC to seek damages under Section 1983 for the alleged violation of his FNHRA-protected rights. The Supreme Court recognized, however, that because private entities own most nursing homes, most nursing homes will not be subject to suit under Section 1983, as it will only apply to publicly owned facilities.
The U.S. Supreme Court’s opinion can be found here.
