Supreme Court Case – Private Right of Action Under NHRA

Talevski ex rel. Talevski v Health & Hosp. Corp.,

No. 21-806,

6 F.4.713 (7th Circ. 2021),

cert. granted, 142 S.Ct. 2673 (2022).

The oral hearing is scheduled for November 8, 2022.

Expenditure: (1) Whether the Supreme Court should review its decision that expenditure clause legislation creates privately enforceable rights 42 U.S.C. § 1983; and (2) whether, assuming that expenditure clause laws give rise to private rights enforceable through Section 1983, the Federal Nursing Home Amendments Act of 1987the transfer and medication rules of .

In that case, the court will consider whether residents have the right to sue state nursing homes to enforce the rights Congress provided in the Nursing Home Reform Act (NHRA). The court will also address the broader question of whether laws enacted under Congress’s Expenditure Clause authority, such as the NHRA, are enforceable by private individuals.

In January 2016, Gorgi Talevski moved to Valparaiso Care and Rehabilitation (VCR), an Indiana state nursing facility, because he needed help coping with his dementia. Complaint and Request for Jury Trial ¶¶ 8-9, Talevski ex rel. Talevski v Health & Hosp. Corp., 19-CV-00013, 2020 WL 1472132 (ND Ind. March 26, 2020). Shortly after his arrival, his condition deteriorated. ID. ¶¶ 10-12. His family learned that Mr. Talevski had received several psychotropic medications. ID. § 14. In January 2017, the facility refused to readmit Mr. Talevski after a hospital visit, forcing him to move to a new facility much further away from his family. ID. ¶ 20. Mr. Talevski’s wife sued to enforce Mr. Talevski’s rights as a nursing home resident, including his rights to be free from chemical restrictions and involuntary transfer or discharge. ID. ¶¶ 2, 40.

In 1987, Congress passed the NHRA to protect and improve the quality of life for nursing home residents. Congress enumerated “residents’ rights,” which include a resident’s right to be free from physical or chemical limitations and the right to remain in a nursing facility without involuntary release or transfer. 42 USC § 1396r(c)(1)(A)(ii), (c)(2)(a). The NHRA has several enforcement mechanisms, but does not specifically authorize individuals to bring a lawsuit if their rights are violated. See ID. Section 1396r(h) (enforcement proceedings). However, the law states that all legal remedies already available to residents under state and federal law will continue to be available. ID. The NHRA is an amendment to the Medicaid program passed by Congress under its authority under the spending clause of the Constitution. Talevski ex rel. Talewski v. Health & Hosp. Corp.6 F.4. 713, 716, 719 (7th Circ. 2021)

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Under 42 USC § 1983, Congress authorized people to bring a civil action when their federal statutory or constitutional rights have been violated by a state actor. See Talewski, 2020 WL 142132, at *1. In response to Talevski’s case, VCR argued that the lawsuit should be dismissed because the NHRA did not create federal rights to enforce. ID. The United States District Court for the Northern District of Indiana analyzed whether the NHRA confers federal rights using a three-part test established by the Supreme Court: (1) whether Congress intended to benefit the plaintiff; (2) whether the law is clear enough for a court to enforce; and (3) whether the law clearly makes government action mandatory rather than optional. ID. (internal citation omitted) (Apply blessing v. Freestone520 US 329 , 340-41 (1997)).

The district court ruled that the NHRA failed to do so blessing Examination and therefore could not be enforced according to § 1983. ID. at 4. It noted that while the NHRA clearly benefits residents, its use of terms such as “quality of life” and “well-being” rendered the NHRA too vague to give a clear indication of Congress’ intent to be a private to grant the right to sue. ID. at 3.

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Ms. Talevski appealed to the Seventh Circuit Court of Appeals, which reversed the decision, finding that the NHRA conferred federal rights that Section 1983 could enforce. Talewski6 F.4th at 715. Specifically, the court found that Congress’ use of the word “rights” in the NHRA, identifying residents as intended beneficiaries of the law, provided clear and administrable guidelines as to what activities nursing facilities can undertake and which are not, and the use of mandatory terms such as “must” indicated that the statute confers individually enforceable federal rights. ID. at 718-20. In that decision, the Seventh Circuit agreed with the Third and Ninth Circuits, who had already determined that the NHRA could be enforced using Section 1983. ID. at 725-26. AARP and the AARP Foundation, along with other nonprofit organizations, filed an amicus brief in support of Mr. and Mrs. Talevski, advocating that nursing home residents be able to use Section 1983 to enforce their rights against government agencies.

VCR petitioned the Supreme Court for certiorari not only to determine whether the NHRA creates federal rights that are privately enforceable under Section 1983, but also whether any Legislation passed under the spending clause can do this. Petition for a certiorari write to i, Heide & Hosp. Talevski ex rel. Talewski, #21-806 (November 23, 2021). A ruling for the petitioner on this broad issue would require the court to overturn its own precedent view that the Spending Clause legislation can create federal rights enforceable using Section 1983. See Wild v. Virginia Hosp. Ass’n496 US 498, 524 (1990).


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Because of the broad nature of the question before the court, the ability of millions of vulnerable people to file lawsuits under Section 1983 to enforce their civil rights at the federal level is at risk. Congress has used its powers in the Spending Clause to pass many laws that give rights to individuals participating in public federal programs, including the Medicaid and Supplemental Nutrition Assistance programs. A Supreme Court decision that rejects years of precedent and strips millions of people of the power to enforce their civil rights will severely weaken people’s ability to protect themselves and hold violators accountable.

Residents of long-term care facilities are particularly vulnerable to the Supreme Court’s decision because even if the court decides that the Spending Clause legislation can create enforceable rights, it could still find that Congress did not intend for residents to privately enforce rights enshrined in the NHRA . This result would deprive residents of care facilities of an important tool in the fight against abuse and neglect.

Recent reports show that residents continue to face abuse, neglect and dangerously poor care at many facilities, including facilities where they are cuffed with chemicals for staff convenience and facilities where they are illegally discharged. Therefore, residents’ right to sue government entities is critical to their quality of life and well-being. The threat of a lawsuit is a powerful deterrent. Enforcement of rules alone is not enough and has been lacking. Furthermore, ensuring legal compliance does nothing to compensate the actual residents whose health and life are at risk when a facility violates their rights. A private right of action is the only tool that can make residents healthy in these circumstances.

Maame Gyamfi

[email protected]

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