No cause of action under Section 1983 to enforce Federal Nursing Home Reform Amendments

42 U.S.C. § 1983 covers a lot of bases when it comes to bringing claims in federal court. But it does have its limits. A recent ruling by Judge Peterson reminds us that claims brought under Section 1983 must be based on a violation of a federal right. Not all federal statutes confer such a right.

John Shanklin suffered a debilitating stroke in 2014. Unable to provide the full-time care that he required, Mr. Shanklin’s wife arranged for him to be cared for at Coulee Medical Center (CMC). Despite being identified as a fall risk by CMC, Mr. Shanklin fell several times while in CMC’s care. He passed away shortly after his last fall.

Mr. Shanklin’s estate filed suit under Section 1983, alleging that CMC’s care violated the Federal Nursing Home Reform Amendments (FNHRA), 42 U.S.C. § 1396r. CMC moved to dismiss the complaint for failure to state a claim. CMC’s argument was that the alleged FNHRA violations, even if proven to have occurred, are not actionable under Section 1983.

To state a claim under Section 1983, a plaintiff “must assert [a] violation of a federal right, not merely a violation of federal law.” Blessing v. Freestone, 520 U.S. 329, 340 (1997) (emphasis in original). Applying that principle, Judge Peterson concluded that the complaint failed to state a claim. Her reasoning was twofold.

First, Judge Peterson ruled that Congress did not intend to create a federal right when it enacted FNHRA. Analyzing the text of the specific provisions that CMC was alleged to have violated, she found no evidence that the statute was designed to confer protected rights on individual patients:

The [FNHRA] provisions that [the estate] is attempting to enforce . . . are all phrased in terms of what the nursing facilities must do, rather than the protections that the patients must receive. Because the nursing facilities are the subjects of the provisions in question, the provisions are not “phrased in terms of the persons benefited” and do not afford individual rights to nursing facility patients.

Second, Judge Peterson concluded that the provisions in question were “too vague or amorphous” to be enforced through Section 1983. If the case were to proceed to trial, she observed, the jury would be asked highly subjective questions such as whether CMC’s services “enhanced the quality of life” for its patients. Had Congress intended for FNHRA violations to be actionable under Section 1983, Judge Peterson reasoned, it surely would have provided a more definite standard for establishing liability.

This is a question of first impression in the Ninth Circuit. Other circuits have taken the opposite view, holding that FNHRA violations are actionable under Section 1983. See Concourse Rehab. & Nursing Ctr. Inc. v. Whalen, 249 F.3d 136, 144 (2d Cir. 2001); Grammer v. John J. Kane Reg’l Ctrs.-Glen Hazel, 570 F.3d 520, 527 (3d Cir. 2009). Those cases, however, involved different subsections of the statute than the subsections that were implicated in this case. It will be interesting to see how the Ninth Circuit decides the question if the case is appealed.

The case is Shanklin v. Coulee Medical Center, Case No. 17-CV-0377-RMP. Shanklin was represented by Jerry Moberg of Jerry Moberg & Associates. Coulee Medical Center was represented by Jim King of Evans, Craven & Lackie.

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