On June 8, 2023, the United States Supreme Court held that nursing home residents may seek monetary damages from employees of government-owned nursing homes for violations of the Federal Nursing Home Reform Act (FNHRA).
The FNHRA contains a set of provisions that ensure nursing homes receiving Medicaid funding respect and protect their residents’ health, safety, and dignity. Prior to the Supreme Court’s decision in Health and Hospital Corporation of Marion County v. Ivanka Talevski, there was uncertainty as to whether individual nursing home residents could bring a private lawsuit to enforce the provisions of the FNHRA and recover monetary damages. Typically, the FNHRA was enforced by the government’s revocation of Medicaid funding from nursing homes found to have violated an FNHRA requirement.
In Health and Hospital Corporation of Marion County, the plaintiff was a resident at a nursing home owned by Health and Hospital Corporation (HHC). HHC was, in turn, owned by Marion County, Indiana. The plaintiff had been diagnosed with dementia prior to admission, but this condition became progressively worse. The resident was allegedly moved to different facilities without the required FNHRA conditions being met. Moreover, the resident’s family alleged that the resident was being inappropriately chemically restrained. The use of chemical restraints and inappropriate transfers, as alleged, can be violations of the FNHRA. The plaintiff sued HHC under 42 U.S.C. § 1983, which is a federal statute that allows for individual, private causes of action against persons who violate an individual’s rights while acting under color of law.
In response to the suit, HHC argued that no private cause of action exists for violation of the FNHRA because it was enacted under Congress’ spending powers, which creates an obligation more akin to a contractual obligation than an enforceable federal “right.” Relying in large part on the text of the FNHRA itself, which repeatedly refers to nursing home residents’ “rights,” the Court disagreed. Accordingly, the Supreme Court held that individuals may sue employees of government-owned nursing homes for violations of the FNHRA.
This decision answered the question of whether violations of the FNHRA are enforceable by private individuals, which opens the door for additional lawsuits. While nominally the decision authorizes only § 1983 claims in the context of government-owned nursing homes, which account for just six percent of all nursing homes in the United States, it is anticipated that plaintiffs will attempt to use the decision as a basis to assert similar claims against privately owned homes that rely on state-issued licensure, receive federal Medicaid funding, and/or contract with governmental entities to provide services. The import of this decision will likely be heavily litigated in the coming years.
If you would like a full copy of the Health and Hospital Corporation of Marion County opinion, or if you have any questions regarding its implications, contact a member of Reminger’s Long-Term Care Liability group.