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1983 FNHRA Litigation Cheat Sheet by

This summary is designed to provide an overview of the law for both residents and facilities.

Who Can Be Sued?

Nursing facilities operated by local or municipal govern­ments

Who Can Sue?

Residents in nursing facilities owned by local or municipal govern­ments

For what acts?

Government agency's policies or customs
Govern­ment's failure to train or supervise its employees
Government employee making a final decision with an effect similar to a policy
For more, see Martin Schwartz, Section 1983 Litigation

In What Jurisd­ict­ions?

Federal Courts in the Third Circuit (has already found the QoL provisions enforc­eable)
Includes Delaware, New Jersey, and Pennsy­lvania.
Federal Courts in the First Circuit (has suggested the QoL provisions are enforc­eable)
Includes Maine, Massac­hus­etts, New Hampshire, Puerto Rico, and Rhode Island.
Federal Courts in Remaining Circuits (have not made rulings on QoL provis­ions)
Includes remaining states.

What Can Be Enforced?

Right to Quality Food
Includes mealtimes and dining experi­ence, when food is offered, and what food is offered
42 U.S.C. § 1396r(­b)(­4)(­A)(iv); 42 CFR § 483.60.
Right to Meaningful Activities
Includes having access to a choice of activi­ties, those activities being meanin­gful, and having access to activities
42 U.S.C. § 1396r(­b)(2), (4)(A)(v); 42 CFR 483.24(c); 42 CFR § 483.10­(f)­(1)­,(3).
Right to be Treated with Respect and Dignity
Includes intera­ctions with staff, as well as policies that enable staff to engage with residents
42 U.S.C. § 1396r(b)(l )(A); 42 C.F.R. § 483.10­(a)(1).



What Cases are Important?

FNHRA and § 1983 Compat­ibility
Health & Hosp. Corp. of Marion Cnty. v. Talevski, 599 U.S. 166 (2023).
§ 1983 Compat­ibi­lity, Generally
Blessing v. Freestone, 520 U.S. 329 (1997); Gonzaga Univ. v. Doe, 536 U.S. 273, 284, 287 (2002).
QoL Provisions Enforc­ement
Grammer v. John J. Kane Reg'l Center­s-Glen Hazel, 570 F.3d 520 (3d Cir. 2009); Rolland v. Romney, 318 F.3d 42, 53 n. 10 (1st Cir. 2003).

What is the FNHRA?

The Federal Nursing Home Reform Act (FNHRA), also referred to as the Omnibus Budget Reconc­ili­ation Act of 1987 (OBRA 87), is the guiding statute for nursing facility law. It details what skilled nursing facili­ties, including nursing homes and assisted living facili­ties, must provide their residents.

What is § 1983?

42 U.S.C. § 1983 says that any person acting under color of state law who deprives a citizen of a Federally granted right, either from the Consti­tution or a federal statute, can be held civilly liable to that person.
"­Under color of state law" means acting with authority of the govern­ment.


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