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Nursing home loses high court battle to shut down lawsuit

The case turns on the power of people who reside in federally funded facilities to enforce their constitutional rights. 

WASHINGTON (CN) — A family prevailed Thursday in their fight to hold a nursing liable for using chemical restraints on a resident with dementia and working for years to have him transferred to a distant facility. 

Justice Ketanji Brown Jackson wrote the opinion for the 7-2 majority, finding that provisions within the Federal Nursing Home Reform Act give nursing home residents rights that can be enforced by courts. 

“We hold that the two FNHRA provisions at issue here do unambiguously create §1983-enforceable rights,” the Biden appointee wrote. “And we discern no incompatibility between private enforcement under §1983 and the statutory scheme that Congress has devised for the protection of those rights. Accordingly, we affirm the lower court’s judgment that respondent’s §1983 action can proceed in court.” 

The case stems from an Indiana family's decision in 2016 to commit Gorgi Talevski to the Valparaiso Care and Rehabilitation, about an hour southeast of Chicago, because his dementia became too much for them to handle alone. Though Talevski still recognized his family at the time of the move, and he could still walk, talk and feed himself, the family says they saw his cognitive and physical abilities decline rapidly once he became a Valparaiso resident. 

The family confirmed that the nursing home was chemically restraining Talevski with a panel of psychotropic drugs, though Valparaiso asserted that the medication was necessary to control Talevski’s behavior. Staff claimed Talevski repeatedly and inappropriately touched female residents and tried to stab the workers with knives and forks. 

Once an outside neurologist helped taper down Talevski’s prescriptions, he was able to walk and feed himself again, but Valparaiso then began sending the man to a psychiatric hospital 90 minutes away for days at a time. After a few such stints, Valparaiso tried to make Talevski a permanent resident at a dementia facility in Indianapolis, nearly three hours away.

Even after state authorities nullified the forced transfer, Valparaiso refused to readmit Talevski. By this point Talevski had acclimated to the facility 90 minutes away from his family where he lived during the drawn-out proceedings. His family opted not to move him, despite it meaning a three-hour journey to visit him roundtrip.

His wife meanwhile sued the nursing home for violations of the Federal Nursing Home Reform Act of 1987, which predicates Medicaid funding for nursing facilities on how the state regulates them. The law says nursing homes must avoid physical or chemical restraints for patients except in certain circumstances. Facilities are also required to allow patients to stay in nursing homes without the threat of transfer or discharge unless certain conditions were met. 

Though a federal judge dismissed the suit, the Seventh Circuit reinstated it, and the high court agreed Thursday that the case by Talevksi's family can proceed. 

Valparaiso argued that the family's arguments contradict court precedent, burdening state and local governments "by litigation costs and hefty damages — arising from unpredictable and shifting multi-factor balancing tests — that they never anticipated when they agreed to accept federal funding."

"Spending Clause legislation, as this Court has noted, derives its constitutional legitimacy from an agreement between the states and the federal government,” Lawrence Robbins with Kramer Levin wrote in a brief for the nursing home.

The Talevksis, represented by Andrew Tutt with Arnold & Porter, argued meanwhile that Congress explicitly authorized nursing home patients to sue for violations of their rights. 

“This case begins and ends with the statutory text,” Tutt wrote in his brief. “When Congress in 42 U.S.C. § 1983 created an express cause of action against those acting under color of state law who deprive individuals of ‘any rights, privileges, or immunities secured by the Constitution and laws’ it meant exactly what it said: suits are authorized for the violation any ‘rights’ ‘secured by’ the ‘laws.’”

The high court’s majority agreed. 

“‘Laws’ means ‘laws,’ no less today than in the 1870s, and nothing in petitioners’ appeal to Reconstruction-era contract law shows otherwise,” Jackson wrote. 

Jackson said the court has previously held provisions within the law can be used to enforce nursing home residents’ rights. 

“Consequently, as we have previously held, §1983 can presumptively be used to enforce unambiguously conferred federal individual rights, unless a private right of action under §1983 would thwart any enforcement mechanism that the rights-creating statute contains for protection of the rights it has created,” Jackson wrote. 

Justice Samuel Alito, joined by Justice Clarence Thomas, wrote in dissent that the law does provide rights for nursing home residents but those rights cannot be enforced. 

“In my view, while respondent has established that the Federal Nursing Home Reform Act (FNHRA) creates individual rights, petitioners have established that relief for the violation of those rights under §1983 is foreclosed by the remedial scheme in the Act,” Alito wrote. 

Neither attorneys for Talveski or Valparaiso Care and Rehabilitation responded to requests for comment on the ruling. 

Follow @KelseyReichmann
Categories / Appeals, Civil Rights, Health, Law

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