U.S. Supreme Court affirms nursing home residents’ right to sue
Nursing home residents can sue providers that accept Medicaid in federal court, the U.S. Supreme Court decided Thursday in an Indiana-born case with implications for millions of Americans.
It was a stunning loss for Marion County’s Health & Hospital Corporation (HHC) — the state’s leading nursing home operator — and a surprise victory for patients, advocates and those who participate in other federal safety net programs.
HHC “urges us to reject decades of precedent,” Justice Ketanji Brown Jackson wrote in the 7-2 majority opinion, calling the agency’s arguments “unpersuasive.”
National case traces roots to dispute in Hoosier state
The case stems from the treatment of Gorgi Talevski at a Valparaiso nursing home operated by HHC. The agency owns 78 facilities within the state.
Talevski’s family filed a lawsuit in 2019 alleging the facility used powerful psychotropic drugs to chemically restrain him, and moved him involuntarily and without prior notice to another facility 90 minutes away in Indianapolis. He died two years later in 2021.
The 1987 Federal Nursing Home Reform Act (FNHRA) places restrictions on both of those practices. Talevski’s wife, Ivanka, alleged HHC violated her husband’s rights.
Ivanka Talevski said she could sue because a short chunk of federal code — Section 1983 — lets any American sue state entities that they believe have violated their
HHC, however, argued that laws Congress enacts via its spending power are exempt under its reading of 1870’s-era common law: if an entity gets federal funding in exchange for complying with federal regulations, that’s like a contract that third parties — patients — can’t butt in on. HHC said other avenues for relief exist.
That argument had implications for not only other nursing home patients, but the millions of people who participate in social safety net programs more broadly: Medicaid, the Supplemental Nutrition Assistance Program, the Children’s Health Insurance Program and Temporary Assistance for Needy Families.
HHC alternately argued that the nursing home act didn’t create a right that patients can seek to enforce via legal action.
“We reject both” of HHC’s central arguments,” Jackson wrote. “‘Laws’ means ‘laws,’ no less today than in the 1870s, and nothing in petitioners’ appeal to Reconstruction-era contract law shows otherwise.”
The court heard the case back in November.
Some celebrate as HHC regroups
Health and social services advocates across the country celebrated in the wake of the decision’s release, with Hoosiers among them.
Seventh District U.S. Rep. Andre Carson of Indiana said in a statement that he was “encouraged” by the decision and “what it means for the countless Americans who rely on social safety net programs to survive.”
“Today’s decision … makes clear our Congressional intent was to provide a remedy and a legal right of action when individuals have been mistreated,” Carson said. He promised to “soon” introduce legislation that would codify the results.
Disability group The Arc, which has an Indiana chapter, called the decision a “monumental win.”
“One in four adults in America has a disability, the majority of whom rely on Medicaid and other safety net programs to live meaningful lives. Because of today’s decision, they will continue to have legal recourse if they face mistreatment or abuse or their benefits are taken away or denied, which happens more often than you may think,” General Counsel Shira Wakschlag said in a statement. “… Private lawsuits have been one of the only ways people can meaningfully enforce their rights in these crucial programs.”
The agency behind the suit, however, said the decision would impact its resources — emphasizing that it is a public rather than for-profit operator.
“HHC brought this case because it has a fiduciary duty to focus its scarce public resources on the health care needs of historically underserved populations,” the agency said in a statement.
“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,” it said.
But Thursday’s decision is unlikely to be the end of the larger legal debate.
Justice Clarence Thomas called for a full re-examination of certain previous decisions and Congress’ spending power in his 35-page dissent. And in a concurrence, Justice Neil Gorsuch argued Talevski’s family didn’t “develop fully” some legal questions.
But he wrote, “As I see it, those are questions for another day.”