The U.S. Supreme Court’s recent and surprising voting rights decision overshadowed another civil rights victory that same day, a ruling with major implications for many American families.
On June 8, 2023, the court, in a 7-2 decision, ruled in Health and Hospital Corporation of Marion County, Indiana v. Talevski that the wife of nursing home resident Gorgi Talevski could sue nursing home owners for violating the Federal Nursing Home Reform Act (FNHRA), and specifically its prohibitions on unnecessary physical and chemical restraints and discharges or transfers without notice to the family.
The majority’s decision was viewed as a crucial victory for the civil rights of not just nursing home residents but also for people with disabilities and individuals protected by discrimination bans under Titles VI and IX of the Civil Rights Act, both of which involve federal funding conditions.
In 2016, Talevski’s family placed Gorgi Talevski in the Valparaiso Care and Rehabilitation’s nursing home when it could no longer care for him because of his dementia. When he entered the facility, he was able to talk, feed himself, walk, socialize, and recognize his family. But later in the year, his condition deteriorated, and Talevski was unable to eat on his own and he lost the ability to communicate.
His daughter suspected and then confirmed with outside physicians that her father was being restrained with six powerful psychotropic medications. With help from an outside neurologist, Gorgi’s medication was tapered down, and he regained the ability to feed himself. His family filed a formal complaint with state inspectors.
But in that same year, the nursing home, claiming that Gorgi was harassing female residents and staff, began transferring him to psychiatric hospital 90 minutes away for several days at a time. The nursing home readmitted him twice but tried to force his permanent transfer and made these transfers without notice to him or his family. Another complaint was filed.
The Rights of Nursing Home Residents
At first blush, it would seem to have been an easy case for the courts: Of course, a person should be able to go to court if the law is being violated. But there was something special about this particular federal law and the civil rights law that was to be the vehicle for the lawsuit.
Congress enacted the FNHRA via its spending clause power in Article I, Section 8 of the Constitution. The act sets quality standards for nursing homes if they receive Medicare or Medicaid. As the Supreme Court made clear in its June 8, 2023 ruling, the typical remedy for failure to comply with the act’s conditions is not a private lawsuit but the termination of federal funds.
But in their lawsuit against the nursing home’s owner, Health and Hospital Corporation, the Talevski family argued that the provisions in the FNHRA conferred individual rights on nursing home residents. Those rights, the family said, were enforceable via a civil rights act from the 1870s, whose first section is known as Section 1983.
Since the early 1870s, Section 1983 has provided an express cause of action to any person deprived (by someone acting under color of state law) of “any rights secured by the Constitution and laws.” While not a catch-all remedy for constitutional violations, it is a powerful tool for vindication of a broad range of constitutional rights.
The Talevski family succeeded in the lower appellate court of persuading that court that FNHRA did create enforceable rights of nursing home residents and that they could be enforced via Section 1983. The corporation then turned to the Supreme Court.
The Court’s Majority Opinion
In a 7-2 opinion by Justice Ketanji Brown Jackson, the majority rejected the corporation’s arguments that spending clause statutes, like FNHRA, are in the nature of contracts between the federal government and the states. A private individual is akin to a third-party beneficiary of that contract. In the 1870s, third-party beneficiaries generally were barred from suing to enforce contract obligations. And so, the argument went, the Tavleskis had no private enforceable rights under Section 1983.
The majority rejected that argument, saying it would require the court to overturn decades of precedents and to rewrite the plain text of Section 1983 to read “laws (unless those laws rest on the Spending Power).”
Justice Jackson wrote: “Hewing to §1983’s text and history (not to mention our precedent and constitutional role), we reject HHC’s request, and reaffirm that ‘laws’ in §1983 means what it says. ‘Laws’ means ‘laws,’ no less today than in the 1870s, and nothing in petitioners’ appeal to Reconstruction-era contract law shows otherwise.”
FNHRA, she also wrote, does unambiguously confer individual rights. The court has a test for determining that issue: where the provision in question is “phrased in terms of the persons benefited” and contains “rights-creating,” individual-centric language with an “unmistakable focus on the benefited class.”
The unnecessary restraint and predischarge-notice provisions in the act, she explained, meet the test because both provisions reside in a section of the law that expressly concerns requirements “relating to residents’ rights.” And she said there was no incompatibility between FNHRA’s own administrative enforcement scheme and Section 1983 enforcement.
Justice Amy Coney Barrett, who, joined by Chief Justice John Roberts Jr., concurred in the opinion, cautioned that Section 1983 actions are the exception not the rule for violations of spending clause laws. She noted that since 1981, the court had found only two spending clause statutes enforceable through Section 1983.
The more comprehensive a statute’s enforcement scheme is, she wrote, “the less likely that leaves the door open for §1983 suits.”
Justices Clarence Thomas and Samuel Alito dissented. Justice Thomas argued that Congress’ spending power is “no more than a disposition of funds” and FNHRA does not secure rights by law. Justice Alito wrote that even though the Talevskis established that the FNHRA creates individual rights, relief via Section 1983 is foreclosed by the act’s own remedial scheme.
For a conservative-led court that has not exactly been generous in its interpretations of civil rights laws, June 8 was a big day.
Marcia Coyle is a regular contributor to Constitution Daily and PBS NewsHour. She was the Chief Washington Correspondent for The National Law Journal, covering the Supreme Court for more than 30 years.