Health & Hospital Corp. v. Talevski, 599 U.S. __, 2023 WL 3872515 (June 8, 2023)

Nursing home residents may sue under 42 U.S.C. § 1983 for FNHRA violations.

Family members placed Gorgi Talevski in a county-owned nursing home in Indiana when his dementia progressed to the point they could no longer care for him. His condition quickly deteriorated. The family attributed his decline to the nursing home’s use of powerful psychotropic medications. When the nursing home began transferring Talevski to a distant psychiatric hospital for days at a time, the family complained to the state health department. An administrative law judge nullified the transfer, but the nursing home ignored the decision and refused to readmit Talevski.  Talevski (via a relative) sued the nursing home’s operator (HHC) in federal court under 42 U.S.C. § 1983, alleging that HHC violated his rights under the Federal Nursing Home Reform Act (FNHRA), a statute enacted by Congress under its Spending Clause authority. The district court dismissed the complaint, ruling that Section 1983 may not be used to enforce the FNHRA. The Seventh Circuit reversed, holding that the FNHRA confers on nursing home residents certain individual rights that may be enforced by litigating under Section 1983.

The Supreme Court granted review and affirmed the Seventh Circuit. The Court explained that Section 1983 supplies a plaintiff with a cause of action against a person (acting under color of state law) who has deprived the plaintiff of rights “secured by the Constitution and laws” of the United States. The “laws” enforceable via Section 1983 are not limited to federal statutes focused on civil rights or equal protection, but neither is every federal statute such a “law[ ].” The Supreme Court considers a variety of factors to determine which federal statutes may be enforced under Section 1983. Here, the Court held that FNHRA provisions create Section 1983-enforceable rights because they contain rights-creating, individual-centric language focused on the benefited class (specifically, FNHRA provisions bar unnecessary restraints and mandate predischarge notice). FNHRA provisions also specify that Medicaid-participant nursing homes must respect and honor these rights. In addition, Congress did not provide a private right of action within the FNHRA, and the Act lacks an internal administrative enforcement scheme that could be thought incompatible with enforcement efforts under Section 1983.

Justice Barrett (joined by the Chief Justice) concurred separately to caution that Section 1983 actions should be the exception (not the rule) for violations of federal statutes enacted under the Spending Clause. The typical remedy for non-compliance with Spending Clause statutes is an action by the federal government to terminate funds to the state, not a private lawsuit. Justice Barrett nonetheless found a private lawsuit suitable in the FNHRA context. Justice Thomas dissented on the ground that Spending Clause statutes like FNHRA should not be enforceable under Section 1983. Spending Clause statutes resemble contracts between states and the federal government, not regulations conferring individual rights. A contrary view (he suggested) could enable Congress to commandeer states to administer federal programs that Congress might otherwise lack authority to enact. Finally, Justice Alito dissented to criticize the majority’s holding that the FNHRA creates Section 1983-enforceable rights given its unique remedial scheme and grievance process.

The bulletin describing this appellate decision was originally prepared for the California Society for Healthcare Attorneys (CSHA) by H. Thomas Watson, Peder K. Batalden, and Lacey Estudillo at the appellate firm Horvitz & Levy LLP, and is republished with permission.

For more information regarding this bulletin, please contact H. Thomas Watson, Horvitz & Levy LLP, at 818-995-0800 or htwatson@horvitzlevy.com.