Page:Health and Hospital Corp. of Marion Co. v. Talevski.pdf/20

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HEALTH AND HOSPITAL CORPORATION OF MARION CTY. v. TALEVSKI

Opinion of the Court

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).[1]

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


  1. The Fourteenth Amendment hardly fails to secure §1983-enforceable rights because it directs state actors not to deny equal protection.