United States Supreme Court Holds That Private Litigants May Bring Civil Rights Action Against Nursing Homes
In Health and Hospital Corporation of Marion County v. Talevski, 599 U.S. _____ (2023 WL 3872515), the United States Supreme Court held that private litigants may bring civil actions against nursing homes under 42 U.S.C. § 1983 for violating provisions of the Federal Nursing Home Reform Act (“FNHRA”).
42 U.S.C. § 1983 (“Section 1983”) is a federal civil rights statute. It was enacted to allow individuals to sue the government and its agents for violations of rights set forth in other federal laws and statutes. The elements of a Section 1983 action generally include: (1) a defendant acting “under color of state law,” and (2) conduct that causes the deprivation of a constitutional or federal statutory right. A common example of a Section 1983 action is a lawsuit filed against a law enforcement officer for use of excessive force. A plaintiff in a Section 1983 lawsuit can recover compensatory damages, punitive damages, and attorney’s fees.
The Talevski decision involved a nursing home resident suffering from dementia. The nursing home allegedly administered psychotropic medications to him as an improper means of chemical restraint. It also allegedly sent him to a psychiatric hospital for several days and then tried to prevent his readmission without first notifying him or his family.
The resident sued the nursing home defendants under Section 1983 for violating his rights as set forth in the FNHRA. More specifically, the resident claimed that the nursing home violated his right to be free from unnecessary chemical restraints (§ 1396r(c)(1)(A)(ii)), and his right to not be discharged or transferred from the facility unless certain preconditions were met (§ 1396r(c)). The defendants filed a motion to dismiss the lawsuit on the grounds that the FNHRA cannot be privately enforced pursuant to a Section 1983 lawsuit. The FNHRA has its own enforcement mechanisms, including state and federal oversight. Defendants essentially claimed that enforcement of the FNHRA should be left to the government, including surveys, sanctions, corrections, and exclusion from Medicaid funding.
The Supreme Court ultimately held that private individuals may enforce the provisions of the FNHRA and seek damages directly from nursing homes under Section 1983. The Supreme Court held that the two FNHRA provisions at issue created rights that are enforceable under Section 1983 and that there was no incompatibility between private enforcement of these rights under Section 1983 and the FNHRA’s separate governmental enforcement mechanisms.
While the Supreme Court’s decision focused on just two specific rights provided by the FNHRA (i.e., the right to be free from unnecessary chemical restraints and the right to not be discharged or transferred unless certain preconditions are met), the Supreme Court’s decision presumably applies to every other resident right set forth in the FNHRA as well. In fact, the Supreme Court held that private individuals may use Section 1983 “to enforce every right that Congress validly and unambiguously creates.”
The result of the Talevski decision will likely be an increase in litigation against nursing homes under Section 1983. While compliance with the FNHRA has always been important, it is also generally known that government agencies have limited resources with which to enforce the provisions of the FNHRA. Private litigants and their attorneys, however, do not have the same limiting resources. They will be even more incentivized than before to take these types of cases. The Supreme Court’s decision will vastly expand the number of parties scrutinizing nursing homes for compliance with the FNHRA. More so than ever before, nursing homes should be investing time and resources into complying with the FNHRA standards, including undertaking proactive measures to prevent violations from arising in the first place.
It should be noted that the nursing home in Talevski was owned by a public entity, i.e., the County of Marion, Indiana. As such, the “acting under color of law” element of Section 1983 was not at issue. The Supreme Court did not address whether its holding also applies to privately owned nursing homes. The determination of whether a defendant is “acting under color of law” is a fact-specific inquiry that takes into account the nature of the defendant’s relationship with the government and the defendant’s specific actions. Just because a nursing home receives Medicare and Medicaid funding does not necessarily mean that it is acting under color of law and, thus, can be sued under Section 1983. Nevertheless, until and unless an appellate court holds that the Talevski decision does not apply to privately owned nursing homes, we anticipate a proliferation of Section 1983 lawsuits against nursing facilities.
