Civil and Human Rights

Nursing Home Residents’ Rights Could Hang on SCOTUS Arguments

The US Supreme Court will hear oral arguments on Tuesday in a case that could make it more difficult for millions of Americans to enforce their civil rights in court against public entities that receive federal government funding.

At issue in this specific case is whether Ivanka Talevski can sue the Health and Hospital Corp. of Marion County, Ind., for violating her late husband’s civil rights. The nursing home allegedly medicated, restrained, and transferred him—a dementia patient—without her knowledge or consent. The Federal Nursing Home Reform Amendments to the Medicaid Act expressly prohibit such conduct.

HHC, a publicly-run nursing facility, says FNHRA doesn’t confer rights enforceable through private lawsuits under Section 1983. There is no express language in the amendments that allows for private enforcement, it said. Congress, moreover, didn’t indicate that it intended to create a private right of action when it adopted FNHRA, the American Health Care Association said in a brief supporting the provider.

But there is a second, broader question: Whether Section 1983 can ever be used as a vehicle to enforce benefits conferred by legislation passed under Congress’ authority to tax and spend that doesn’t expressly allow plaintiffs to do so.

A win for HHC on that question could affect millions of people who participate in other federally funded, state- or local government-administered programs, both Medicaid and non-Medicaid, who potentially will be left with little recourse, Talevski said. Rights conferred on them by various programs will be “illusory,” she said. Medicaid alone serves more than 87 million low-income people throughout the US.

Groups supporting Talevski, like the Constitutional Accountability Center in Washington, say that Section 1983 couldn’t be clearer. It provides people with a vehicle to sue anyone who, acting under color of state law, deprives them of “any rights, privileges, or immunities secured by the Constitution and laws.”

Contract Law

Several interested entities argued that contract-law principles compel a ruling that people can’t sue government actors under Section 1983 to enforce conditions in spending clause legislation unless it’s specifically allowed.

Under the common-law in place in 1871, when Section 1983 was enacted, third parties mostly couldn’t sue to enforce a contract—even when they were the beneficiaries of it. The same rule should apply here, the nursing home said in its brief. The Supreme Court applied contract-law principles in a spending clause case it decided just last term, HHC added.

This case presents an “enormous” contract law question, John Bursch told Bloomberg Law. Bursch is Senior Counsel and Vice President of Appellate Advocacy with Alliance Defending Freedom and represents South Carolina.

A uniform, broad rule would clarify the “muddy” waters left by high court precedent that has recognized an implied right to sue in some instances, Bursch said.

Twenty-two states supporting HHC, including Indiana, also want the top court to adopt a “clear, principled rule” that puts states that accept federal money to run programs like Medicaid on clear notice of when they will potentially face private lawsuits to enforce federal conditions—namely, only when a federal program expressly allows for private suits, the states said.

States must be given a chance to “voluntarily and knowingly accept” the terms of a federal grant, including the fact that their acceptance could expose them to litigation, they said. Medicaid accounts for about one-third of state budgets—Indiana alone received $11.9 billion in fiscal year 2021, according to the states’ friend of the court brief.

Well-Established Law

But it’s well-established that Section 1983 gives people a way to vindicate their rights and government actors an incentive to ensure programs work the way they’re supposed to. It doesn’t allow “atextual carve-outs” for spending clause legislation, Brianne Gorod, chief counsel at CAC, said. CAC filed a friend of the court brief supporting Talevski.

Medicaid isn’t the only spending clause program that would be affected if the court rules for the nursing home, Maame Gyamfi, Senior Attorney for AARP Foundation said. AARP also supported Talevski in an amicus brief.

“Congress has used its spending clause power to pass many laws that give rights to people who participate in federal public programs” including Supplemental Nutrition Assistance Programs, Gyamfi said.

“A Supreme Court decision rejecting years of precedent and stripping away the power of millions of people to enforce their civil rights will substantially weaken the ability of people to protect themselves and hold violators accountable,” Gyamfi said.

Broad Ruling Unnecessary

The American Health Care Association, which represents nursing facilities throughout the country, argued for a narrow decision holding only that FNHRA doesn’t authorize private litigation to enforce its conditions. James Segroves, a partner at Reed Smith LLP in Washington, filed the group’s amicus brief.

The top court should look at what Congress intended when it adopted FNHRA, Segroves said. There is no indication in the text that Congress intended for states to be faced with a “sledgehammer of Section 1983 litigation,” he said.

It seems especially unlikely Congress intended to create a system that potentially burdens only the minority of public nursing facilities that participate in the Medicaid program, Segroves said. More than 80% of facilities are run by private companies that aren’t subject to suit under Section 1983, he said.

Residents and their families won’t be helpless if the court rules for the facility, Segroves added. They will still be able to file complaints with state or federal Medicaid agencies, he said.

HHC asked the court to overturn a decision by the US Court of Appeals for the Seventh Circuit that denied the facility’s motion to dismiss Talevski’s case. The Seventh Circuit’s decision was in line with rulings from the Third and Ninth circuits.

Friedman Kaplan Seiler & Adelman LLP represents Health and Hospitals Corp. Arnold & Porter Kaye Scholer represents Talevski.

The case is Health & Hosp. Corp. of Marion Cty., Ind. v. Talevski, U.S., No. 21-806, oral arguments scheduled 11/8/22.

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