This morning, the Supreme Court ruled that residents and their surviving heirs/family members can sue a publicly owned nursing home under the Federal Nursing Home Reform Act. The court upheld a lower court ruling against the Health and Hospital Corporation of Marion County (HHC). This organization operates publicly owned (governmental) SNFs in Indiana. A couple of months ago, I wrote about this case in another post. Readers can access the post here: https://wp.me/ptUlY-vu
HHC had argued that the existing federal Conditions of Participation for SNFs governing Medicare and Medicaid participation was the proper avenue for recourse against care violations or other procedural violations, not civil court.
In this case, a family (Tavelski) sued HHC for mistreatment regarding the use of psychotropic medications and transfers to other facilities without permission/patient (or designated surrogate) consent. HHC alleged that the Tavelski family could not pursue civil action but instead, had to use administrative remedies available to them in the federal and state SNF code.
The fundamental question that was addressed was whether patients/families could pursue civil action via the courts against publicly (county/state) facilities under the Nursing Home Reform Act of 1987 OR, was the sole course of remedies available, only via administrative law (grievance, appeals, etc.) through CMS. The Court found that nothing in the Nursing Home Reform Act precluded a family/patient from accessing the courts for remedies, if applicable.
The decision will have far-reaching implications beyond nursing home residents/families having a right of private legal action. The decision will branch to other matters involved Medicaid access, insurance rights, benefit qualifications, prior authorization, enrollment, etc., including for families and children with respect to Medicaid. Prior law required redress of any issues to be made through the applicable state or federal agency via administrative appeals.
The full Supreme Court decision is available here: Tavelski Decision 6 8 23
Hello There
This is an interesting development. It seems like nursing home residents and their families now have more legal options when it comes to holding public facilities accountable. I’m curious to see how this plays out in practice.
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This is such great news! It’s important for nursing home residents and their families to have a way to hold public facilities accountable for any mistreatment or neglect. This decision by the Supreme Court is a step in the right direction for ensuring the rights and safety of vulnerable individuals.
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