Federally-protected rights of nursing home residents

I’m Katelyn Holub, an attorney focusing on personal injury law in northwest Indiana.

Welcome to Personal Injury Primer, where we break down the law into simple terms, provide legal tips, and discuss personal injury law topics.

Today’s episode takes a look at a recent case decided by the Supreme Court of the United States about the rights of a nursing home resident as it pertains to the right to be free from chemical restraints imposed for purposes of discipline or convenience rather than treatment as well as the right not to be transferred or discharged from a nursing home facility unless certain criteria are met. Health & Hosp. Corp. v. Talevski, 143 S. Ct. 1444 (2023).

The case centered on the language of a couple of provisions in the Federal Nursing Home Reform Act.  In general, the Act is a federal law that sets forth minimum standards of care that state-run nursing homes must meet to receive Medicaid funds. The Act also has a section that lists out certain rights of nursing home residents regarding their health and safety.

Included in that list of the rights of nursing home residents are provisions regarding the right to be free from restraints and the right not to be transferred or discharged from a nursing home facility unless certain prerequisites are met.

The Supreme Court affirmed the 7^th Circuit appellate court, answering the question about whether parts of the Federal Nursing Home Reform Act setting forth certain rights for nursing home residents to receive federal funding through the Medicaid program also conferred private rights of action under 42 U.S.C. § 1983 for nursing home residents to sue nursing homes for alleged violations of those rights.

The Court determined that the Act did confer privately enforceable rights of action under 42 U.S.C. § 1983 regarding the right to be free from restraints and not to be transferred or discharged from a nursing home facility unless certain prerequisites are met.

What is 42 U.S.C. § 1983, and why is it important? The short answer is it is a federal law that gives an express cause of action to any person deprived (by someone acting under color of state law) of rights, privileges, or immunities secured by the US Constitution and federal laws.

Here, the federal law was the Federal Nursing Home Reform Act. The specific language of the Act enumerating the rights of a nursing home resident to be free from restraints provides:

The right to be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms. Restraints may only be imposed—

(I) to ensure the physical safety of the resident or other residents, and

(II) only upon the written order of a physician that specifies the duration and circumstances under which the restraints are to be used …

The other right of a nursing home resident described in the Federal Nursing Home Reform Act that was at issue in this lawsuit is the right not to be transferred or discharged from a nursing home facility unless certain criteria are met. Section 1396r(c)(2) of the Act specifies under which a nursing home is permitted to transfer or discharge a resident and provides that a nursing home “must permit each resident to remain in the facility and must not transfer or discharge the resident from the facility unless:

(i) the transfer or discharge is necessary to meet the resident’s welfare and the resident’s welfare cannot be met in the facility;

(ii) the transfer or discharge is appropriate because the resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility;

(iii) the safety of individuals in the facility is endangered;

(iv) the health of individuals in the facility would otherwise be endangered;

(v) the resident has failed, after reasonable and appropriate notice, to pay for a stay at the facility; or

(vi) the facility ceases to operate.

Basically, the Federal Nursing Home Reform Act sets out pre-transfer and pre-discharge notice requirements and clinical record documentation requirements, which effectively create a right for residents of nursing homes to remain at a facility unless these enumerated requirements are met.

Now, in determining whether a federal statute creates a private right that is enforceable under § 1983, there are several factors that courts look at. Ultimately, the courts have to decide whether the text and structure of the federal statute at issue unambiguously establishes an individual right for a specific class of beneficiary.

Here, the US Supreme Court found that the parts of the Federal Nursing Home Reform Act dealing with the right to be free from restraints and the right not to be transferred or discharged unless certain criteria are met specifically identified nursing home residents as the intended beneficiary of said statutory provisions and that those parts of the statute unambiguously conferred individually enforceable rights to nursing home residents to bring their own private causes of actions against a nursing home facility for alleged violation of those rights under § 1983.

The Court found that the statutory provisions used clear rights-creating language and had a particular focus on the benefited class of people—namely nursing home residents.

I hope you found this information helpful. If you are a victim of someone’s carelessness, substandard medical care, product defect, work injury, or another personal injury, please call (219) 736-9700 with your questions. You can also learn more about us by visiting our website at DavidHolubLaw.com – while there, make sure you request a copy of our book “Fighting for Truth.”