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United States Third Circuit Court of Appeals Permits Residents of County-Operated Nursing Homes the Right to Bring Claims Under 42 U.S.C. § 1983

On June 30, 2009, in an opinion offered by the Honorable Richard Lowell Nygaard, the U.S. Third Circuit Court of Appeals permitted an action against a county operated nursing home to proceed under 42 U.S.C. § 1983 for violations of the Omnibus Budget Reconciliation Act of 1987 (OBRA) and the Federal Nursing Home Reform Amendments (FNRA), 42 U.S.C. § 1396r et seq.

The action was brought by the daughter of a resident against a nursing home operated by Allegheny County. The complaint contained two counts, one for wrongful death, the other for survival. It alleged that as a result of the nursing home’s failure to render proper care to her mother, her mother developed decubitus ulcers, became malnourished, and eventually developed sepsis which plaintiff alleged caused her mother’s death.

The case was dismissed pursuant to Fed.R.Civ.P. 12(b)(6) after the nursing home filed a motion to dismiss. The District Court held that there was no private right of action under OBRA and FNRA. Plaintiff appealed to the Third Circuit Court of Appeals.

In finding that there was a private right of action under FNRA, the Third Circuit cited Blessing v. Freestone, 520 U.S. 329 (1997) for the three factors to determine whether a statute conveys a federal right upon an individual. The Third Circuit explained these factors to be 1) whether Congress intended that the statutory provision in question benefits the plaintiff; 2) whether the right asserted was so “vague and amorphous” that its enforcement would strain judicial competence, and 3) whether the statute unambiguously imposes a binding obligation on the states. Noting that all factors had been met, the Third Circuit then inquired into whether the statutes in question unambiguously conferred a substantive right in accordance with the Supreme Court’s decision in Gonzaga Univ. v. Doe, 536 U.S. 273 (2002).

In addressing this issue, the Third Circuit noted that the provisions of FNHRA contained numerous references to rights created and is clearly phrased in terms of persons benefitted, and therefore, held that an action against a county operated nursing home could proceed under 42 U.S.C. § 1983 for violations of OBRA and FNHRA.

Noting that plaintiff had met her burden, the Third Circuit noted that the burden then shifted to defendant to rebut the presumption of an enforceable right under § 1983. However, defendant failed to argue that Congress precluded enforcement of rights conferred by FNHRA, and the Third Circuit’s assessment of the Medicaid Act uncovered no evidence of congressional intent to preclude enforcement of these rights.


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