The Seventh Circuit held July 27 that a nursing home resident could sue the facility where he resided for alleged violations of the Federal Nursing Home Reform Act (FNHRA).

Reversing a lower court decision, Talevski v. Health and Hosp. Corp., No. 2:19 CV 13 (N.D. Ind. Mar. 26, 2020), the Seventh Circuit held that the FNHRA provisions at issue created individual rights that were enforceable through a 42 U.S.C. § 1983 claim. The Third and Ninth Circuits also have found a private right of action under FNHRA. See, e.g., Grammer v. John J. Kane Reg’l. Ctrs., 570 F.3d 520 (3d Cir. 2009); Anderson v. Ghaly, 930 F.3d 1066, 1075 (9th Cir. 2019). But several district courts under the purview of the Seventh Circuit had refused to find such a right.

Plaintiff Gorgi Talevski was a resident at defendant nursing home Valparaiso Care and Rehabilitation, a state-run nursing facility near his home in Indiana. Through his wife, he sued Valparaiso Care and related entities under Section 1983 for violating his rights under FNHRA—specifically, the right to be free from chemical restraints not related to treatment and the right not to be transferred or discharged unless certain criteria are met.

Applying the three-factor test articulated in Blessing v. Freestone, 520 U.S. 329 (1997), and other Supreme Court precedent, the Seventh Circuit held the FNHRA provisions created and conferred a federal right to individual residents.

The appeals court noted both provisions included unmistakable “rights-creating language” that was couched in mandatory terms. In addition, the asserted rights were not “so vague and amorphous” that would make it too difficult for agencies and the courts to determine whether they had been violated.

“Facilities must protect and promote the right against chemical restraints, must allow residents to remain in the facility, must not transfer, and must not discharge the resident; these are unambiguous obligations,” the appeals court said.

The Seventh Circuit also rejected Valparaiso Care’s argument that federal and state enforcement schemes impliedly foreclosed Section 1983 claims.

Annual compliance surveys and the requirement that states provide a fair mechanism for hearing appeals on transfers and discharges of residents did not amount to “the type of comprehensive enforcement scheme, incompatible with individual enforcement,” the appeals court said.

Talevski v. Health and Hosp. Corp. of Marion Cty., No. 20-1664 (7th Cir. July 27, 2021).

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In simple terms, this landmark judgment means that nursing home residents have the right to sue their facilities for violating the Federal Nursing Home Reform Act (FNHRA), adding weight to previous decisions by the Third and Ninth Circuits.

What is the FNHRA and why is it important? The FNHRA was passed by Congress in 1987 as part of the Omnibus Budget Reconciliation Act. It sets forth a number of standards related to nursing home care, from staffing requirements to patients’ rights, in an effort to guarantee a base level of quality of care for residents in nursing homes that receive Medicare or Medicaid funding.

The FNHRA emphasizes the importance of patient autonomy and quality of life, including provisions that residents have a right to be free from unnecessary and inappropriate restraint and that they cannot be discharged or transferred arbitrarily. These rights were at the heart of the Talevski case.

The Seventh Circuit’s decision underscores the enforceability of these rights, recognizing that residents have a legitimate claim when these rights are violated.

This judgment, in essence, sends a clear message to nursing homes: The law mandates that you must respect residents’ rights, and you can and will be held accountable if you violate them. This is a substantial win for advocates of elder rights, who have long argued for better enforcement of nursing home regulations. It also gives individuals and their families a potent tool to fight against mistreatment and to demand better quality of care.

Nursing home care is an issue of profound importance, affecting millions of people across the country. The FNHRA was designed to ensure that nursing home residents, who are often vulnerable and unable to advocate for themselves, receive the care and dignity they deserve. The Seventh Circuit’s ruling in Talevski v. Health and Hosp. Corp. reinforces this fundamental promise.

The verdict is also a wake-up call to nursing homes to ensure they are fully compliant with the FNHRA. Nursing homes are now on notice that failure to abide by the standards set forth in the FNHRA could result in legal liability.

In conclusion, the Talevski ruling provides a significant step forward in safeguarding nursing home residents’ rights. It offers a clear affirmation of the rights of some of the most vulnerable members of society and reinforces the importance of respecting these rights in all healthcare settings. It’s a reminder to us all that the provision of care should be rooted in respect and dignity, regardless of one’s age or medical condition.