Health and Hospital Corporation of Marion County v. Talevski/Opinion of the Court

by Supreme Court of the United States

Notice: This opinion is subject to formal revision before publication in the preliminary print of the United States Reports. Readers are requested to notify the Reporter of Decisions, Supreme Court of the United States, Washington, D. C. 20543, of any typographical or other formal errors, in order that corrections may be made before the preliminary print goes to press.

SUPREME COURT OF THE UNITED STATES

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No. 21–806

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HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY, ET AL., PETITIONERS v. IVANKA TALEVSKI, AS PERSONAL REPRESENTATIVE OF THE ESTATE OF GORGI TALEVSKI, DECEASED
ON WRIT OF CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE SEVENTH CIRCUIT
[June 8, 2023]

Justice Jackson delivered the opinion of the Court.

The Federal Nursing Home Reform Act (FNHRA or Act) ensures that nursing homes that receive Medicaid funding respect and protect their residents’ health, safety, and dignity. Provisions of the FNHRA refer to rights of nursing-home residents to be free from unnecessary physical or chemical restraints and to be discharged or transferred only when certain preconditions are satisfied. This case is about these particular provisions and whether nursing-home residents can seek to vindicate those FNHRA rights in court.

Respondent Ivanka Talevski maintains that she can enforce the rights these particular FNHRA provisions describe via 42 U. S. C. §1983, which, since the 1870s, has provided an express cause of action to any person deprived (by someone acting under color of state law) of “any rights … secured by the Constitution and laws.” Petitioners insist that respondent is wrong about being able to rely on §1983 in this context, for two independent reasons. First, petitioners urge us to discard our longstanding recognition that §1983’s unqualified reference to “laws” “means what it says,” Maine v. Thiboutot, 448 U. S. 1, 4 (1980), and to rule instead that §1983 contains an implicit carveout for laws that Congress enacts via its spending power—a holding that, according to petitioners, would mean that §1983 could not be used to enforce any rights the FNHRA purports to recognize. In the alternative, petitioners point to our established methods for determining whether a statutory provision creates a §1983-enforceable right and maintain that these FNHRA provisions do not create rights that nursing-home residents can enforce via §1983.

We reject both propositions. “Laws” means “laws,” no less today than in the 1870s, and nothing in petitioners’ appeal to Reconstruction-era contract law shows otherwise. Consequently, as we have previously held, §1983 can presumptively be used to enforce unambiguously conferred federal individual rights, unless a private right of action under §1983 would thwart any enforcement mechanism that the rights-creating statute contains for protection of the rights it has created. Fitzgerald v. Barnstable School Comm., 555 U. S. 246, 253–255 (2009); Gonzaga Univ. v. Doe, 536 U. S. 273, 284, and n. 4 (2002). We hold that the two FNHRA provisions at issue here do unambiguously create §1983-enforceable rights. And we discern no incompatibility between private enforcement under §1983 and the statutory scheme that Congress has devised for the protection of those rights. Accordingly, we affirm the lower court’s judgment that respondent’s §1983 action can proceed in court.

I

In 2016, when Gorgi Talevski’s dementia progressed to the point that his family members could no longer care for him, they placed him in petitioner Valparaiso Care and Rehabilitation’s (VCR) nursing home.^[1] When he entered VCR, Mr. Talevski could talk, feed himself, walk, socialize, and recognize his family. Later in 2016, however, Mr. Talevski’s condition suddenly deteriorated. He became unable to eat on his own and began losing the ability to communicate in English (leaving him to rely primarily on Macedonian, his native language).

VCR staff claimed this was dementia’s natural progression. But Mr. Talevski’s daughter suspected, and then confirmed with outside physicians, that VCR was chemically restraining Mr. Talevski with six powerful psychotropic medications. With the help of an outside neurologist, his medication was tapered down, and he began to regain the ability to feed himself. Around this time, the Indiana State Department of Health (Department) conducted its periodic inspection of VCR, and the Talevskis filed a formal complaint with the inspectors regarding the chemical restraints.

The problems did not end there. Toward the end of 2016, VCR began asserting that Mr. Talevski was harassing female residents and staff. Based on that claim, VCR began sending Mr. Talevski to a psychiatric hospital 90 minutes away for several days at a time. VCR readmitted Mr. Talevski the first two times it sent him away. But the third time, instead of accepting him back, VCR tried to force his permanent transfer to a dementia facility in Indianapolis. It executed these changed circumstances without first notifying Mr. Talevski or his family.

The Talevskis filed a complaint with the Department regarding Mr. Talevski’s forced transfer. While the complaint was pending, Mr. Talevski had to stay at another facility that was 90 minutes away from his family. Eventually, a Department administrative law judge nullified VCR’s attempted transfer of Mr. Talevski. Based on that determination, the Talevskis endeavored to have Mr. Talevski returned to VCR. But VCR ignored the judge’s decision and refused readmission.

The Talevskis complained again to the Department, which later issued a report regarding the Talevskis’ complaints. Subsequently, petitioner American Senior Communities LLC (ASC), which manages VCR, contacted Mr. Talevski’s wife, Ivanka, to discuss the possibility of Mr. Talevski’s return. At this point, however, Mr. Talevski had acclimated to his new home, and the Talevskis feared retribution against him if he returned to VCR. So they opted to leave him in the new facility, which meant that every family visit required a 3-hour round trip.

In 2019, Mr. Talevski (through Ivanka) sued VCR, ASC, and petitioner Health and Hospital Corporation of Marion County (collectively, HHC) under Rev. Stat. §1979, 42 U. S. C. §1983.^[2] The lawsuit claimed that HHC’s treatment of Mr. Talevski—in particular, the use of chemical restraints and the persistent transfer attempts—had violated rights that the FNHRA guaranteed him as a nursing-home resident. The District Court granted HHC’s subsequent motion to dismiss the complaint, reasoning that no plaintiff can enforce provisions of the FNHRA via §1983.

The Court of Appeals for the Seventh Circuit reversed. It concluded that, under this Court’s precedent, the relevant FNHRA provisions “unambiguously confer individually enforceable rights on nursing-home residents,” making those rights presumptively enforceable via §1983. 6 F. 4th 713, 720 (2021). The Court of Appeals held further that the presumption had not been rebutted here, because nothing in the FNHRA indicated congressional intent to foreclose §1983 enforcement of these rights. Id., at 720–721.

HHC filed a petition for certiorari, which we granted.^[3] 596 U. S. ___ (2022). For the reasons explained below, we affirm the Seventh Circuit’s judgment.

II
A

As relevant here, §1983 provides that

“[e]very person who, under color of any statute, ordinance, regulation, custom, or usage, of any State or Territory or the District of Columbia, subjects, or causes to be subjected, any citizen of the United States or other person within the jurisdiction thereof to the deprivation of any rights, privileges, or immunities secured by the Constitution and laws, shall be liable to the party injured in an action at law, suit in equity, or other proper proceeding for redress.”

That is, any person within the jurisdiction of the United States may invoke this cause of action against any other person who, acting “under color of” state law, has deprived them of “any rights, privileges, or immunities secured by the Constitution and laws” of the United States.

We have been asked before to narrow the scope of this express authorization, i.e., to read “laws” to mean only “civil rights or equal protection laws.” Thiboutot, 448 U. S., at 6. We declined to do so, reasoning that a straightforward reading of the “plain language” of §1983 is required. Id., at 4. That should have been no surprise; “Congress attached no modifiers to the phrase [‘and laws’].” Ibid.

Since Thiboutot, we have crafted a test for determining whether a particular federal law actually secures rights for §1983 purposes. See Gonzaga, 536 U. S., at 283–285; Part III–B, infra. But we have not previously doubted that any federal law can do so.

B
1

HHC attempts to sow renewed doubt about §1983’s textually unqualified sweep by proffering “historical evidence.” Brief for Petitioners 3; see also id., at 2 (asserting that “[f]or most of this nation’s history, individuals did not have a recognized private right to enforce obligations prescribed by federal statutes”). As background for our evaluation of the particulars of HHC’s Spending Clause-based argument regarding §1983’s meaning, see Part II–B–2, infra, a fuller picture of the relevant historical context is warranted. United States v. Union Pacific R. Co., 91 U. S. 72, 79 (1875); accord, Towne v. Eisner, 245 U. S. 418, 425 (1918) (Holmes, J., for the Court).

Before the Civil War, few direct federal protections for individual rights against state infringements existed. The Thirteenth, Fourteenth, and Fifteenth Amendments worked a sea change in this regard. See McDonald v. Chicago, 561 U. S. 742, 754 (2010); Fitzpatrick v. Bitzer, 427 U. S. 445, 453–456 (1976); Ex parte Virginia, 100 U. S. 339, 344–345 (1880). Still, neither these Civil War Amendments nor the landmark Civil Rights Act of 1866 successfully prevented postbellum state actors from continuing to deprive American citizens of federally protected rights. Mitchum v. Foster, 407 U. S. 225, 240 (1972).

In early 1871, a Senate Select Committee produced and distributed a Report that ran hundreds of pages and recounted pervasive state-sanctioned lawlessness and violence against the freedmen and their White Republican allies. Monroe v. Pape, 365 U. S. 167, 174 (1961) (citing S. Rep. No. 1, 42d Cong., 1st. Sess. (1871)).^[4] After reading the Report, President Ulysses S. Grant implored Congress to act.

It is against this backdrop that the 42d Congress enacted, and President Grant signed, the Civil Rights Act of 1871. The first section of that statute, as reenacted in 1874, created the federal cause of action now codified as §1983. Chapman v. Houston Welfare Rights Organization, 441 U. S. 600, 608, and n. 16 (1979) (citing Rev. Stat. §1979 (1874)). The “plain language[’s]” lack of “modifiers,” Thiboutot, 448 U. S., at 4, reflected the regrettable reality that “state instrumentalities” could not, or would not, fully protect federal rights, Mitchum, 407 U. S., at 242.

We have adhered to this understanding of §1983’s operation. To guarantee the protection of federal rights, “the §1983 remedy … is, in all events, supplementary to any remedy any State might have.” Owens v. Okure, 488 U. S. 235, 248 (1989) (internal quotation marks omitted); Knick v. Township of Scott, 588 U. S. ___, ___ (2019) (slip op., at 11). And we have consistently refused to read §1983’s “plain language” to mean anything other than what it says. Thiboutot, 448 U. S., at 4–6 (observing that our cases, running back to at least 1968, only make sense if “laws” indeed means “laws”).

2

We are not persuaded by HHC’s argument (which Justice Thomas supports, see post, at 1, 35 (dissenting opinion)), that Talevski cannot invoke §1983 to vindicate the rights the FNHRA provisions at issue here purport to recognize because Congress seems to have enacted the FNHRA pursuant to the spending power recognized in Article I, §8, of the Constitution.^[5]

HHC’s argument generally proceeds as follows. Starting with our precedent regarding Congress’s spending power, HHC begins by emphasizing our observation that federal legislation premised on that power is “much in the nature of a contract,” because, “in return for federal funds, the States agree to comply with federally imposed conditions.” Pennhurst State School and Hospital v. Halderman, 451 U. S. 1, 17 (1981); see also Cummings v. Premier Rehab Keller, 596 U. S. ___, ___ (2022) (slip op., at 4). HHC then seizes on the “contract” analogy to create a syllogism. It reasons that (1) any private party suing to enforce an obligation between Federal and State Governments that a Spending Clause statute creates is, essentially, a “third-party beneficiary” (by which HHC means beneficiaries of rights created in any such statute); and (2) under common-law contract principles extant at the time that Congress enacted §1983, third-party beneficiaries were “generally” barred from suing to enforce contract obligations; therefore, (3) plaintiffs like Talevski, as a purported third-party beneficiary of the FNHRA, may not use §1983 to do something that third-party beneficiaries of contracts generally could not do in the 1870s. Brief for Petitioners 13, 17–18 (citing 1870s treatises and state cases).

The upshot, for HHC, is that “Spending Clause statutes do not give rise to privately enforceable rights under Section 1983” because contracts were not “generally” enforceable by third-party beneficiaries at common law. Id., at 11, 13. On this basis alone, HHC thus, in effect, urges us to reject decades of precedent, and to rewrite §1983’s plain text to read “laws (unless those laws rest on the Spending Power).”

Two well-established principles, applied here, suffice to reject HHC’s invitation to reimagine Congress’s handiwork (and our precedent interpreting it).

First, our prior §1983 cases reference “ ‘firmly rooted’ ” common-law principles. Wyatt v. Cole, 504 U. S. 158, 164 (1992). We implement Congress’s choices rather than remake them. Azar v. Allina Health Services, 587 U. S. ___, ___–___ (2019) (slip op., at 14–15). Thus, we have reasoned that Congress’s failure to displace firmly rooted common-law principles generally indicates that it incorporated those established principles into §1983. Wyatt, 504 U. S., at 163–164.^[6] Here, HHC’s key common-law plank—that third-party beneficiaries could not sue to enforce contractual obligations during the relevant time—is, at a minimum, contestable. See Brief for Contract Law Professors et al. as Amici Curiae 4 (“[A] majority of American jurisdictions … permit[ted] third-party beneficiaries to sue through at least the early 1870s”); see also Hendrick v. Lindsay, 93 U. S. 143, 149 (1876) (concluding that “the right of a party to maintain assumpsit on a promise not under seal, made to another for his benefit, … is now the prevailing rule in this country”).^[7] “[S]omething more than ‘ambiguous historical evidence’ is required before we will ‘flatly overrule a number of major decisions of this Court,’ ” Gamble v. United States, 587 U. S. ___, ___ (2019) (slip op., at 11), as HHC essentially asks us to do here.

Second, because “[t]here is no doubt that the cause of action created by §1983 is, and was always regarded as, a tort claim,” Monterey v. Del Monte Dunes at Monterey, Ltd., 526 U. S. 687, 727 (1999) (Scalia, J., concurring in part and concurring in judgment), HHC’s particular focus on 1870s law governing third-party-beneficiary suits in contract is, at the very least, perplexing. If there is a reason that the principles governing those suits should be read to displace the plain scope of §1983’s “ ‘species of tort liability,’ ” Heck v. Humphrey, 512 U. S. 477, 483 (1994), HHC has utterly failed to identify it.

We have no doubt that HHC wishes §1983 said something else. But that is “an appeal better directed to Congress.” Nieves v. Bartlett, 587 U. S. ___, ___ (2019) (Gorsuch, J., concurring in part and dissenting in part) (slip op., at 2). Hewing to §1983’s text and history (not to mention our precedent and constitutional role), we reject HHC’s request, and reaffirm that “laws” in §1983 means what it says. Thiboutot, 448 U. S., at 4.^[8]

III

The FNHRA can create §1983-enforceable rights. But do the two FNHRA provisions at issue in this case actually do so? In that respect, our precedent sets a demanding bar: Statutory provisions must unambiguously confer individual federal rights. Gonzaga, 536 U. S., at 280. For the reasons explained below, we conclude that the bar has been cleared with respect to the presently contested provisions. And while the FNHRA itself might nevertheless evince Congress’s intent to preclude the use of §1983 to enforce these particular rights, id., at 284, n. 4, we hold further that it does not.

A

The FNHRA provisions at issue in this case, like the rest of the Act, stem from a longstanding national commitment to provide safe and dignified care for the elderly. Since as early as the Social Security Act of 1935, federal law has aimed in myriad ways to promote nursing homes that provide quality services. Yet, concerns about the poor condition of such facilities persisted even after Congress enacted the 1965 Medicare and Medicaid Acts,^[9] partly due to widespread noncompliance with existing federal and state laws. See Institute of Medicine, Improving the Quality of Care in Nursing Homes 2–3, 11, 241–246 (1986); H. R. Rep. No. 100–391, pt. 1, pp. 448–452 (1987). Thus, in 1987, Congress passed, and President Ronald Reagan signed, the FNHRA, effecting a “seismic shift” in nursing-home quality standards. B. Furrow, T. Greaney, S. Johnson, T. Jost, & R. Schwartz, Health Law 51 (3d ed. 2015) (Health Law).^[10] The FNHRA is largely composed of a litany of statutory requirements that Congress laid out for Medicaid-participant States and “nursing facilities.” §1396a(a)(28).^[11] Those include “[r]equirements relating to residents’ rights,” §1396r(c) (boldface deleted), two of which Talevski’s complaint invoked.

The first requires nursing facilities to “protect and promote” residents’ “right to be free from … any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.” §1396r(c)(1)(A)(ii) (referred to herein as “the unnecessary-restraint provision”). The second appears in a subparagraph concerning “[t]ransfer and discharge rights,” §1396r(c)(2)(A) (boldface deleted), and tells nursing facilities that they “must not transfer or discharge [a] resident” unless certain enumerated preconditions, including advance notice of such a transfer or discharge, are met. E.g., §§1396r(c)(2)(A)–(B) (referred to herein as “the predischarge-notice provision”).

As for enforcement, like other aspects of Medicaid, the FNHRA anticipates “cooperative federalism”—i.e., federal and state actors working together—to carry out the statute’s aims. Wisconsin Dept. of Health and Family Servs. v. Blumer, 534 U. S. 473, 495 (2002). Thus, qualifying State Medicaid plans, which are approved by the Secretary of the U. S. Department of Health and Human Services (HHS Secretary), §1396a(b), must include provisions that relate to nursing facilities, and must require “any nursing facility receiving payments under” the plan to satisfy certain FNHRA mandates. §1396a(a)(28). The HHS Secretary must also “assure that” approved state plans—and “the enforcement of [plan] requirements”—are, inter alia, “adequate” to “protect the health, safety, welfare, and rights of [nursing-home] residents.” §1396r(f)(1).

The FNHRA also establishes a detailed administrative scheme for government inspections of nursing facilities. §1396r(g). “Surveys” (in the statute’s parlance) must be conducted to detect nursing homes that are falling short of the FNHRA’s minimum standards, and state and federal officials must periodically file certifications, based on these surveys, regarding nursing-home compliance, see §1396r(g)(1)(A). In addition, the statute authorizes government actors to sanction and correct noncompliant facilities, or, if appropriate, exclude them from the Medicaid program entirely. §1396r(h); see also Health Law 56–63.

B
1

Although federal statutes have the potential to create §1983-enforceable rights, they do not do so as a matter of course. For Spending Clause legislation in particular, we have recognized that “ ‘the typical remedy for state noncompliance with federally imposed conditions is not a private cause of action for noncompliance but rather action by the Federal Government to terminate funds to the State.’ ” Gonzaga, 536 U. S., at 280 (quoting Pennhurst, 451 U. S., at 28). The parties here thus dispute whether this is the atypical case; that is, whether the unnecessary-restraint and predischarge-notice provisions of the FNHRA “unambiguously confe[r]” individual rights, making those rights “presumptively enforceable” under §1983. 536 U. S., at 283–284.

Gonzaga sets forth our established method for ascertaining unambiguous conferral. Courts must employ traditional tools of statutory construction to assess whether Congress has “unambiguously conferred” “individual rights upon a class of beneficiaries” to which the plaintiff belongs. Id., at 283, 285–286; see also Rancho Palos Verdes v. Abrams, 544 U. S. 113, 120 (2005). Notably, it must be determined that “Congress intended to create a federal right” for the identified class, not merely that the plaintiffs fall “within the general zone of interest that the statute is intended to protect.” Gonzaga, 536 U. S., at 283 (emphasis deleted). This paradigm respects Congress’s primacy in this arena and thus vindicates the separation of powers. Id., at 286.

We have held that the Gonzaga test is satisfied where the provision in question is “ ‘phrased in terms of the persons benefited’ ” and contains “rights-creating,” individual-centric language with an “ ‘unmistakable focus on the benefited class.’ ” Id., at 284, 287 (emphasis deleted). Conversely, we have rejected §1983 enforceability where the statutory provision “contain[ed] no rights-creating language”; had “an aggregate, not individual, focus”; and “serve[d] primarily to direct the [Federal Government’s] distribution of public funds.” Id., at 290.

If a statutory provision surmounts this significant hurdle, it “secure[s]” §1983-enforceable rights, consistent with §1983’s text. And because “§1983 generally supplies a remedy for the vindication of rights secured by federal statutes,” rights so secured are deemed “presumptively enforceable” under §1983. Gonzaga, 536 U. S., at 284.

2

The unnecessary-restraint and predischarge-notice provisions meet this test. To start, we note that both reside in 42 U. S. C. §1396r(c), which expressly concerns “[r]equirements relating to residents’ rights.” Ibid. (emphasis added; boldface deleted); see also West Virginia v. EPA, 597 U. S. ___, ___ (2022) (slip op., at 16) (statutory provisions “ ‘must be read in their context and with a view to their place in the overall statutory scheme’ ”). This framing is indicative of an individual “rights-creating” focus. Gonzaga, 536 U. S., at 284. Examined further, the text of the unnecessary-restraint and predischarge-notice provisions unambiguously confers rights upon the residents of nursing-home facilities.

The unnecessary-restraint provision requires nursing homes to “protect and promote … [t]he right to be free from … any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.” §1396r(c)(1)(A)(ii) (emphasis added). The provision’s enumerated exceptions further sustain the focus on individual residents. For example, nursing homes may use restraints “to ensure the physical safety of the resident or other residents,” but “only upon the written order of a physician that specifies the duration and circumstances under which the restraints are to be used” (absent emergency circumstances specified by the HHS Secretary). §§1396r(c)(1)(A)(ii)(I)–(II) (emphasis added).

The predischarge-notice provision is more of the same. Nestled in a paragraph concerning “transfer and discharge rights,” §1396r(c)(2) (emphasis added; boldface deleted), that provision tells nursing facilities that they “must not transfer or discharge [a] resident” unless certain preconditions are met, including advance notice of the transfer or discharge to the resident and his or her family. §§1396r(c)(2)(A)–(B) (emphasis added). And, again, the statute’s caveats remain focused on individual residents: A nursing home may transfer or discharge such an individual if, among other things, the transfer is “necessary to meet the resident’s welfare”; or if the resident’s health has improved so much that the facility is no longer necessary; or if the safety or health of other individuals would be endangered. §1396r(c)(2)(A) (emphasis added). The exceptions to the advance-notice requirement, too, turn (inter alia) on the “resident’s health,” the “resident’s urgent medical needs,” or the existence of threats to the safety or health of other individuals in the nursing home. §§1396r(c)(2)(B)(ii)(I)–(III) (emphasis added).

To be sure, these two provisions also establish who it is that must respect and honor these statutory rights; namely, the Medicaid-participant nursing homes in which these residents reside. See, e.g., §§1396a(a)(28), 1396r(c)(1)(A), 1396r(c)(2)(A); see also §§1396r(c)(1)(B)(i)–(ii) (requiring nursing homes to inform nursing-home residents of their rights, orally and in writing, upon admission and upon request). But that is not a material diversion from the necessary focus on the nursing-home residents, contrary to HHC’s representations. Indeed, it would be strange to hold that a statutory provision fails to secure rights simply because it considers, alongside the rights bearers, the actors that might threaten those rights (and we have never so held).^[12]

The unnecessary-restraint and predischarge-notice provisions thus stand in stark contrast to the statutory provisions that failed Gonzaga’s test in Gonzaga itself. Those provisions lacked “rights-creating language,” primarily directed the Federal Government’s “distribution of public funds,” and had “an aggregate, not individual, focus.” 536 U. S., at 290. The opposite is true here. The unnecessary-restraint and predischarge-notice provisions use clear “rights-creating language,” speak “ ‘in terms of the persons benefited,’ ” and have an “ ‘unmistakable focus on the benefited class.’ ” Id., at 284, 287, 290 (emphasis deleted). Thus, they satisfy Gonzaga’s stringent standard, and the rights they recognize are presumptively enforceable under §1983.

C

Even if a statutory provision unambiguously secures rights, a defendant “may defeat t[he] presumption by demonstrating that Congress did not intend” that §1983 be available to enforce those rights. Rancho Palos Verdes, 544 U. S., at 120.^[13] For evidence of such intent, we have looked to “the statute creating the right.” Ibid. A statute could, of course, expressly forbid §1983’s use. Fitzgerald, 555 U. S., at 252; Rancho Palos Verdes, 544 U. S., at 120. Absent such a sign, a defendant must show that Congress issued the same command implicitly, by creating “a ‘comprehensive enforcement scheme that is incompatible with individual enforcement under §1983.’ ” Id., at 120. Only the latter path is at issue here.

1

Our precedent outlines what HHC must show to traverse the implicit-preclusion path. “ ‘The crucial consideration’ ” is whether “Congress intended a statute’s remedial scheme to ‘be the exclusive avenue through which a plaintiff may assert [his] claims.’ ” Fitzgerald, 555 U. S., at 252 (quoting Smith v. Robinson, 468 U. S. 992, 1009, 1012 (1984) (emphasis added)); Fitzgerald, 555 U. S., at 252 (framing “ ‘[t]he critical question’ ” as “ ‘whether Congress meant [the statute’s remedial scheme] to coexist with … a §1983 action’ ” (quoting Rancho Palos Verdes, 544 U. S., at 120–121)).

Our precedents make clear that the sine qua non of a finding that Congress implicitly intended to preclude a private right of action under §1983 is incompatibility between enforcement under §1983 and the enforcement scheme that Congress has enacted. 555 U. S., at 252–254. We have used many terms and concepts to describe the necessary discordance between §1983 and a rights-conferring statute’s remedial scheme: “ ‘incompatible,’ ” “ ‘inconsistent,’ ” and “thwar[t]” are examples. Id., at 252–255. In all events, the question is whether the design of the enforcement scheme in the rights-conferring statute is inconsistent with enforcement under §1983, such that a court must infer that “Congress did not intend” to make available the “[§1983] remedy for [these] newly created right[s].” Rancho Palos Verdes, 544 U. S., at 120; see also Fitzgerald, 555 U. S., at 252.

Put another way, the inquiry boils down to what Congress intended, as divined from text and context. The application of the traditional tools of statutory construction to a statute’s remedial scheme may reveal no incompatibility between the enforcement scheme that Congress crafted in the rights-conferring statute and enforcement under §1983, or it may uncover sufficient incompatibility to make manifest Congress’s intent to preclude §1983 actions. See, e.g., id., at 253 (explaining a past implicit-preclusion case on the ground that permitting §1983 claims there would have “thwarted Congress’ intent”); Rancho Palos Verdes, 544 U. S., at 127 (§1983’s operation would have “distort[ed]” the pertinent other statute’s remedial scheme).

2

We discern no incompatibility between the FNHRA’s remedial scheme and §1983 enforcement of the rights that the unnecessary-restraint and predischarge-notice provisions unambiguously secure.

As explained in Part III–A, supra, the FNHRA details administrative processes concerning inspection of covered nursing facilities and accountability for noncompliant facilities. But the statute lacks any indicia of congressional intent to preclude §1983 enforcement, such as an express private judicial right of action or any other provision that might signify that intent. See, e.g., id., at 121 (“[T]he existence of a more restrictive private remedy [in the statute itself] for statutory violations has been the dividing line between those cases in which we have held that an action would lie under §1983 and those in which we have held that it would not”). Nor has HHC otherwise demonstrated that enforcement via §1983 would thwart the operation of the administrative remedial scheme in any respect.

HHC’s argument that we need look no further than the detail of the FNHRA’s enforcement mechanisms to find conclusive evidence of implicit preclusion is unpersuasive. Implicit preclusion is shown by a “ ‘comprehensive enforcement scheme that is incompatible with individual enforcement under §1983.’ ” Fitzgerald, 555 U. S., at 252 (emphasis added). HHC’s single-minded focus on comprehensiveness mistakes the shadow for the substance, and it disregards the import of these FNHRA provisions’ unambiguous conferral of rights. The attendant presumption is that §1983 can play its textually prescribed role as a vehicle for enforcing those rights, even alongside a detailed enforcement regime that also protects those interests, so long as §1983 enforcement is not “ ‘incompatible’ ” with Congress’s handiwork. Rancho Palos Verdes, 544 U. S., at 120, 122; Blessing v. Freestone, 520 U. S. 329, 347–348 (1997) (collecting cases).

To be clear, a defendant can discharge its burden of showing that the presumption is rebutted by pointing to a comprehensive scheme. Middlesex County Sewerage Authority v. National Sea Clammers Assn., 453 U. S. 1, 20 (1981) (statutory “remedial devices” that are “sufficiently comprehensive … may suffice” to show implicit preclusion). But when a particular comprehensive remedial scheme discharges the defendant’s burden, it does so because the application of ordinary interpretive tools reveals incompatibility, i.e., it demonstrates that “Congress intended [that] statute’s remedial scheme to be the ‘exclusive avenue through which a plaintiff may assert [his] claims.’ ” Fitzgerald, 555 U. S., at 252.

Nothing in the FNHRA indicates the incompatibility evinced in our three prior cases finding implicit preclusion. Rancho Palos Verdes, 544 U. S., at 120–123, 127; Smith, 468 U. S., at 1008–1013; Sea Clammers, 453 U. S., at 6–7, 19–21. Rancho Palos Verdes, Smith, and Sea Clammers concerned statutes with self-contained enforcement schemes that included statute-specific rights of action. Rancho Palos Verdes, 544 U. S., at 120–123; Smith, 468 U. S., at 1008–1012; Sea Clammers, 453 U. S., at 6–7, 17, and n. 27, 19–21. Each such statute required plaintiffs to “comply with particular procedures and/or to exhaust particular administrative remedies” under the statute’s enforcement scheme before suing under its dedicated right of action. Fitzgerald, 555 U. S., at 254. And each statute-specific right of action offered fewer benefits than those available under §1983. Ibid., and n. 1. Thus, in all three cases, §1983’s operation would have thwarted Congress’s scheme coming and going: It would have “circumvented” the statutes’ presuit procedures, and would have also “given plaintiffs access to tangible benefits” as remedies that were “unavailable under the statutes.” Id., at 254. Those “ ‘comprehensive enforcement scheme[s]’ ” were “ ‘incompatible with individual enforcement under §1983.’ ” Id., at 252 (quoting Rancho Palos Verdes, 544 U. S., at 120).

HHC has identified no equivalent sign in the FNHRA; nor has Justice Alito, see post, at 1, 3–5 (dissenting opinion). In focusing on what the FNHRA contains, they ignore what it lacks—a private judicial right of action, a private federal administrative remedy, or any “ ‘carefu[l]’ ” congressional “ ‘tailor[ing],’ ” Fitzgerald, 555 U. S., at 255, that §1983 actions would “distort,” Rancho Palos Verdes, 544 U. S., at 127. HHC seems to think it enough to show that Congress was not slipshod in crafting the remedial scheme. But in a world where the FNHRA’s remedial scheme could “complement,” not “supplant, §1983,” id., at 122, HHC must demonstrate more than that.

One last rebuttal argument warrants addressing. The United States says that, because private entities owned most nursing homes when the FNHRA was enacted in 1987 (as they do now), the FNHRA is a rare bird for implicit-preclusion purposes. In the United States’ view, because Congress knew that most nursing homes could not be subject to suit under §1983 anyway, see, e.g., Polk County v. Dodson, 454 U. S. 312, 317–319 (1981), the FNHRA’s remedial scheme “necessarily reflects Congress’s judgment that these administrative enforcement mechanisms appropriately protect the rights the statute confers,” Brief for United States as Amicus Curiae 31.

This argument is unavailing. The implicit-preclusion inquiry looks to “the statute creating the right” and any “ ‘comprehensive enforcement scheme’ ” Congress has created in the statute “ ‘that is incompatible with individual enforcement under §1983.’ ” Rancho Palos Verdes, 544 U. S., at 120 (emphasis added). It does not invite speculation about ostensible marketplace realities that appear nowhere in the statute’s text or relevant context. The relevant FNHRA provisions speak in neutral terms that do not distinguish between private and public nursing homes. And, regardless, the question remains whether something in the FNHRA has foreclosed §1983’s “genera[l]” availability as “a remedy for the vindication of rights secured by federal statutes.” Gonzaga, 536 U. S., at 284. We see no such sign, much less a license for us to construct and impute congressional intent that the FNHRA does not embody.

The difficulty for HHC and the United States is that implicit preclusion, in this context, requires something in the statute that shows that permitting §1983 to operate would “thwar[t] Congress’ intent” in crafting the FNHRA. Fitzgerald, 555 U. S., at 253. We see nothing in the FNHRA that even hints at Congress’s intent in this regard; if anything, the language of the Act confirms otherwise, for it plainly states that “[t]he remedies provided under” its enforcement-process subsection are “in addition to those otherwise available under State or Federal law and shall not be construed as limiting such other remedies.” §1396r(h)(8) (emphasis added).^[14] We will not rewrite §1396r(h)(8) in lieu of rewriting §1983.^[15] *** At oral argument, HHC’s counsel remarked that the “right question” is “what rights are secured by law within the meaning of §1983.” Tr. of Oral Arg. 39. That is an accurate statement of the key issue in this case. Section 1983 itself provides the answer. By its terms, §1983 is available to enforce every right that Congress validly and unambiguously creates; we will not impose a categorical font-of-power condition that the Reconstruction Congress did not. And, here, the test that our precedents establish leads inexorably to the conclusion that the FNHRA secures the particular rights that Talevski invokes, without otherwise signaling that enforcement of those rights via §1983 is precluded as incompatible with the FNHRA’s remedial scheme.

Accordingly, we affirm the judgment of the Court of Appeals.

It is so ordered.

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1. We rely for these facts on the operative complaint’s well-pleaded allegations. See Walden v. Fiore, 571 U. S. 277, 281, n. 2 (2014).
2. Marion County, Indiana, owns Health and Hospital Corporation, which in turn wholly owns VCR.
3. After the Seventh Circuit’s ruling, Mr. Talevski passed away. We granted Ivanka Talevski’s substitution motion, and substituted her as a party at the same time we granted certiorari. See Supreme Court Rule 35.1. Subsequent references to Talevski encompass both Talevskis insofar as Ivanka is advancing Gorgi’s interests.
4. Encapsulating the Report, victim testimony, and press accounts for his colleagues, one Congressman (as Monroe noted) lamented that “ ‘murder is stalking abroad in disguise, … whippings and lynchings and banishment have been visited upon unoffending American citizens, [and] the local administrations have been found inadequate or unwilling to apply the proper corrective.’ ” 365 U. S., at 175 (quoting Cong. Globe, 42d Cong., 1st Sess., App. 374 (1871)). Another, summing up the same facts, stated:

   “ ‘Sheriffs, having eyes to see, see not; judges, having ears to hear, hear not; witnesses conceal the truth or falsify it; grand and petit juries act as if they might be accomplices. … [A]ll the apparatus and machinery of civil government, all the processes of justice, skulk away as if government and justice were crimes and feared detection. Among the most dangerous things an injured party can do is to appeal to justice.’ ” Mitchum, 407 U. S., at 241 (quoting Cong. Globe, 42d Cong., 1st Sess., App. 78).

5. See Art. I, §8, cl. 1 (authorizing the Legislature to “lay and collect Taxes … to pay the Debts and provide for the common Defence and general Welfare of the United States”).
6. For example, we have recognized immunities in the §1983 context when a “ ‘tradition of immunity was so firmly rooted in the common law and was supported by such strong policy reasons that “Congress would have specifically so provided had it wished to abolish” ’ ” that particular immunity. Wyatt, 504 U. S., at 164 (quoting Owen v. Independence, 445 U. S. 622, 637 (1980)); see also Tenney v. Brandhove, 341 U. S. 367, 372–376 (1951) (rooting immunity in a well-settled, pre-Revolutionary tradition that Congress could not be thought to have “covert[ly]” abrogated). We relied on similar reasoning when consulting well-settled common-law principles to determine the “contours of a [§1983] claim,” Nieves v. Bartlett, 587 U. S. ___, ___ (2019) (slip op., at 12), the accrual date for §1983 claims, McDonough v. Smith, 588 U. S. ___, ___ (2019) (slip op., at 5) (citing, inter alia, Heck v. Humphrey, 512 U. S. 477, 483 (1994)), and “prerequisites for th[e] recovery” of monetary damages, id., at 483 (citing Carey v. Piphus, 435 U. S. 247, 257–258 (1978)).
7. Black’s Law Dictionary 154 (11th ed. 2019) (defining assumpsit, as relevant, as a “common-law action for … breach of a contract”).
8. HHC’s reply brief retreats from its initial ask, by appearing to concede that Spending Clause legislation can secure individual rights under §1983, but (it says) only if the statutory language “giv[es] funding recipients clear notice.” Reply Brief 1. This newly minted argument contradicts the opening brief’s categorical claims about the scope of §1983. In any event, the well-established requirement that Congress must have “unambiguously conferred” a §1983-enforceable right in a Spending Clause statute ensures the clear notice that HHC’s reply brief requests. Gonzaga Univ. v. Doe, 536 U. S. 273, 279–280, 283 (2002); Part III, infra.
9. Medicare “provides Government-funded health insurance to” millions of “elderly or disabled Americans,” while Medicaid “provides health insurance to all low-income individuals, regardless of age or disability.” Becerra v. Empire Health Foundation, for Valley Hospital Medical Center, 597 U. S. ___, ___–___ (2022) (slip op., at 2–3).
10. The Omnibus Budget Reconciliation Act of 1987 added the FNHRA to Title XIX of the Social Security Act, i.e., Medicaid. See 101 Stat. 1330–182. The FNHRA added a materially identical section to the Medicare-focused portion of the Social Security Act, 101 Stat. 1330–160, 42 U. S. C. §1395i–3 et seq. Because Talevski’s complaint relies only on the Medicaid-related FNHRA provisions, App. to Pet. for Cert. 76a, we hereafter follow the parties and the Court of Appeals in referring only to the pertinent Medicaid provisions, as codified in the U. S. Code (§§1396a(a)(28), 1396r).
11. “Nursing facility” is the FNHRA’s term for a nursing home. §1396r(a).
12. The Fourteenth Amendment hardly fails to secure §1983-enforceable rights because it directs state actors not to deny equal protection.
13. The “ ‘rebuttable presumption’ ” that our cases describe, Rancho Palos Verdes, 544 U. S., at 120, is not an artificially onerous court-made hurdle. It merely reflects what §1983’s plain text commands: The §1983 remedy is available to vindicate federal individual rights “secured by … la[w].” In other words, the presumption recognizes that, even where Congress has unambiguously secured certain federal individual rights by law, it may have simultaneously given good reason (detectable with ordinary interpretive tools) to conclude that the §1983 remedy is not available for those rights, even though it “generally” is. Gonzaga, 536 U. S., at 284, and n. 4. And it also recognizes that it is the defendant’s burden to show that a right otherwise secured by law is not §1983 enforceable. Rancho Palos Verdes, 544 U. S., at 120; Gonzaga, 536 U. S., at 284, and n. 4.
14. We found similar (but not identical) language to be insufficient to preserve the presumption in Middlesex County Sewerage Authority v. National Sea Clammers Assn., 453 U. S. 1 (1981), and Rancho Palos Verdes v. Abrams, 544 U. S. 113 (2005). See id., at 125–127. But those clauses did not purport to preserve “other remedies,” and were embedded in statutes that (unlike the FNHRA) contained private judicial rights of action. See ibid.; Sea Clammers, 453 U. S., at 6–7, 20, and n. 31. The FNHRA’s explicitly expressed objective of preserving other remedies bolsters our reluctance to infer implicit displacement of the §1983 remedy. We think Justice Alito’s response in this regard overreads Rancho Palos Verdes. See post, at 6. That case merely provided an unremarkable description of Sea Clammers’ “refus[al] to read” the saving clauses there as preserving §1983 actions, in light of the different (and significant) textual and contextual evidence of preclusion that the statutes at issue provided. Rancho Palos Verdes, 544 U. S., at 127.
15. The United States’ suggestion that §1396r(h)(8) just ensures that remedies available under non-FNHRA, non-§1983 statutes remain available is not persuasive. Brief for United States as Amicus Curiae 34. Nothing in the Act supports interpreting §1396r(h)(8)’s language in that manner, especially given §1983’s unqualified command.