Supreme Court upholds right to sue public nursing homes

The Supreme Court upheld an individual right to sue public nursing homes for violated rights protected under a federal law that sets standards for these institutions. 

The court affirmed an appeals court ruling in a 7-2 decision that found a private individual can sue for rights protected by the Federal Nursing Home Reform Act through Section 1983 of the federal code, which allows someone to sue for their federal civil rights. 

The case arose after a man named Gorgi Talevski moved into a county-owned nursing home in Indiana in 2016. Talevski had dementia that his family was unable to care for, but he was able to talk, feed himself, walk and recognize his family. 

But Talevski’s condition significantly deteriorated that year, and his family learned that the nursing home, Valparaiso Care and Rehabilitation, was chemically restraining him. The medications were later reduced and allowed him to be able to feed himself again. 

The nursing home later asserted that Talevski was harassing female residents and staff and began sending him to a psychiatric hospital, according to the court’s ruling. But it eventually tried to force him to permanently move to a dementia facility without notifying him or his family. 

Talevski’s wife, Ivanka, sued the nursing home, its manager American Senior Communities LLC and the Health and Hospital Corporation of Marion County (HHC), arguing that they violated her husband’s civil rights protected by the federal nursing home law. 

A district court approved a motion to dismiss the lawsuit, ruling that the provisions of the law could not be enforced through Section 1983. A federal appeals court reversed that ruling, finding that the law does “unambiguously confer individually enforceable rights on nursing-home residents.” 

Supreme Court Justice Ketanji Brown Jackson writing for the majority agreed with the appeals court. She noted that the court has long considered Section 1983, allowing individuals to sue for violations of their rights “secured by the Constitution and federal laws,” to include all laws. 

HHC argued that the word “laws” should only refer to civil rights or equal protection laws as Section 1983 was originally enacted in the aftermath of the Civil War and to specifically protect the rights of newly freed former slaves and their allies. 

HHC argued that the federal nursing home law was enacted based on the Constitution’s Spending Clause, which grants Congress the power to spend money. The law requires that nursing homes meet certain standards to receive funding for Medicare and Medicaid. 

But Jackson rejected these arguments, ruling that the section’s “plain language” means all laws are included. 

HHC argued that the nursing home law essentially is a contract between the federal government and state governments, and third parties like Talevski would not have been able to sue for their rights at the time Section 1983 was put into effect. 

Jackson ruled that the court’s established principles reject this. 

“We have no doubt that HHC wishes §1983 said something else. But that is ‘an appeal better directed to Congress,’” she said in the ruling. 

An HHC spokesperson told The Hill that it brought the case to the Supreme Court because of its responsibility to concentrate its “scarce” resources on historically underserved populations.

They said HHC’s goal was to understand from the court what the status of the law was on federal claims regarding nursing homes.

“With the Court’s definitive answer today that Medicaid-supported nursing home residents have both administrative and federal court remedies for alleged violations, HHC will continue to work to manage those operations safely and effectively and analyze the impact of the decision on those public resources,” the spokesperson said.

Justices Samuel Alito and Clarence Thomas dissented in the ruling.

Alito argued that the federal law already has a process for remedy in place for disputes and allowing lawsuits through Section 1983 would disrupt that. 

“By specifying limited remedies for federal authorities and tasking States with otherwise determining the consequences for violations, the Act creates a clear division of authority that ensures States retain their historical control over nursing-home regulation,” Alito wrote. “Allowing §1983 suits will upset this balance by allowing any plaintiff to demand damages regardless of the remedial regime that States establish pursuant to their explicit authority under the Act.”

Thomas argued that legislation enacted through the congressional power to spend, like the nursing home law, does not secure any rights by law.

“The Court must, at some point, revisit its understanding of the spending power and its relation to §1983,” he said.

—Updated at 6:24 p.m.