In a landmark opinion that recognizes a new category of lawsuits, the 3rd U.S. Circuit Court of Appeals ruled yesterday that the Federal Nursing Home Reform Amendments (FNHRA), 42 U.S.C. § 1396r et seq, gives residents of county-run nursing homes the right to bring civil rights claims to challenge the quality of their treatment. grammar-v-john-j-kane-regional-centers, No. 06-cv-00781, W. D. PA.,  June 30, 2009).

Melviteen Daniels, was a resident of the John J. Kane Regional Center in Pittsburgh, Pennsylvania. The Kane Center is a residential skilled nursing care and rehabilitation center operated by Allegheny County. After Mrs. Daniels died while a resident of the Kane Center, Mrs. Daniels daughter, Sarah Daniels, was appointed administratrix of her estate and filed a lawsuit against the facility which alleged that her mother’s death was caused by the Kane Center’s failure to provide proper care. Grammer brought a claim under 42 U.S.C. §1983 for wrongful death, among other claims, and alleged that the Kane Center deprived Mrs. Daniels of her civil rights by breaching a duty to ensure quality care under the FNHRA. The Kane Center filed a motion to dismiss, arguing that the FNHRA does not provide a right that is enforceable through §1983. The Kane Center maintained that the statute merely set forth requirements a nursing facility must comply with to receive federal Medicaid funds. The District Court dismissed the case, finding no private right of action under the statute.

On appeal, the Third Circuit Court of Appeals reversed. The Court held that the language used throughout the FNHRA is “explicitly and unambiguously rights-creating.” The Court found that the provisions of the law “make clear that nursing homes must provide a basic level of service and care for residents and Medicaid patients,”

Under the law, the Court wrote, nursing homes “are required to care for residents in a manner promoting quality of life, provide services and activities to maintain the highest practicable physical, mental and psychosocial well-being of residents, and conduct comprehensive assessments of their functional abilities.” The FNHRA “specifically guarantees nursing home residents the right to be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraints imposed for the purposes of discipline or convenience and not required to treat their medical symptoms.” As a result, the Court concluded that Congress intended to create a private right of action, enforceable through §1983.

One judge dissented from the majority’s opinion. According to the dissent, “Congress did not speak with a ‘clear voice’ or manifest an ‘unambiguous intent’ to provide a basis for private enforcement of funding requirements under Section 1983.”