# Health and Hospital Corporation of Marion County v. Talevski/Opinion of Justice Alito

SUPREME COURT OF THE UNITED STATES
No. 21–806
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 Alito, with whom Justice Thomas joins, dissenting.
I agree with the Court’s understanding of the high bar required to bring an action under 42 U. S. C. §1983 for the violation of a federal statute, but I disagree with how that standard applies in this case. In my view, while respondent has established that the Federal Nursing Home Reform Act (FNHRA) creates individual rights, petitioners have established that relief for the violation of those rights under §1983 is foreclosed by the remedial scheme in the Act.
I
The majority and Justice Barrett correctly identify the plaintiff’s burden under §1983: a statute “must unambiguously confer individual federal rights” to create “rights” within the meaning of §1983, and “Gonzaga sets forth our established method for ascertaining unambiguous conferral.” Ante, at 11, 14 (majority opinion); see ante, at 1–2 (Barrett, J., concurring); Gonzaga Univ. v. Doe, 536 U. S. 273 (2002). In other words, “if Congress wishes to create new rights enforceable under §1983, it must do so in clear and unambiguous terms.” Id., at 290. Because the standard demands “no less and no more than what is required for ​Congress to create new rights enforceable under an implied private right of action,” I also agree that there is no room for “a multifactor balancing test to pick and choose which federal requirements may be enforced by §1983 and which may not.” Id., at 286, 290 (emphasis added) (rejecting the standard articulated in Blessing v. Freestone, 520 U. S. 329, 340–341 (1997)). None of this is new ground. We have previously held that Gonzaga “plainly repudiate[s] the ready implication of a §1983 action that” our earlier decisions “exemplified.” Armstrong v. Exceptional Child Center, Inc., 575 U. S. 320, 330, n. (2015).
The two FNHRA provisions that respondent invokes demonstrate what it takes to satisfy this demanding standard. First, the Act mandates that a “nursing facility must protect and promote the rights of each resident, including … [t]he right to be free from … chemical restraints imposed for purposes of discipline or convenience and not required to treat medical symptoms.” 42 U. S. C. §1396r(c)(1)(A). Second, the Act protects “[t]ransfer and discharge rights,” precluding a “nursing facility” from transferring or discharging “each resident” except in certain circumstances. §1396r(c)(2)(A) (boldface deleted). Both of these provisions explicitly use the term “rights” to describe discrete and concrete duties that a defined party (“nursing facility”) owes to a particular individual (“each resident”). When these features are taken together, they satisfy the standard for determining whether a personal right exists. See Gonzaga, 536 U. S., at 285–286; Alexander v. Sandoval, 532 U. S. 275, 288–289 (2001).
II A
When determining whether individual rights are enforceable under §1983, I again see much common ground with the majority and agree entirely with Justice Barrett’s explanation of the governing standard. That question “boils ​down to what Congress intended, as divined from text and context.” Ante, at 18 (majority opinion). Notably, we have explicitly held that this standard does not demand anything close to the level of incompatibility required to trigger implied repeal. See Rancho Palos Verdes v. Abrams, 544 U. S. 113, 120, and n. 2 (2005); see ante, at 2 (opinion of Barrett, J.). Instead, the question is simply “whether the rights created by a later statute ‘may be asserted within the remedial framework’ of the earlier one.” Rancho Palos Verdes, 544 U. S., at 120, n. 2; see Great American Fed. Sav. & Loan Assn. v. Novotny, 442 U. S. 366, 375–378 (1979). As the majority explains, §1983 does not apply where Congress has created an individual right but also “simultaneously given good reason (detectable with ordinary interpretive tools) to conclude that the §1983 remedy is not available.” Ante, at 17, n. 13; see, e.g., Armstrong, 575 U. S., at 328 (presumption of equitable remedies rebutted by administrative remedies and statutory requirements).
Finally, I agree that there is no bright-line rule for when a statute evidences an intent to preclude §1983 relief. See Rancho Palos Verdes, 544 U. S., at 122; ante, at 19–21 (majority opinion); ante, at 3–4 (opinion of Barrett, J.). Courts should consider a “wide range of contextual clues, like ‘enforcement provisions’ ” that government officials can invoke and “any ‘administrative remedies that the statute offers.’ ” Ante, at 3 (opinion of Barrett, J.). Whatever the context, the “more comprehensive the [enforcement] scheme” in a statute, “the less likely that it leaves the door open for §1983 suits.” Ibid. After all, when a statute “ ‘provides its own comprehensive enforcement scheme, the requirements of that enforcement procedure may not be bypassed by bringing suit directly under §1983.’ ” Middlesex County Sewerage Authority v. National Sea Clammers Assn., 453 U. S. 1, 20 (1981).
B
When all is said and done, my disagreement with the majority is thus narrowly focused on how this standard applies to this case. In my view, FNHRA “foreclose[s] a private cause of action” even though it “admittedly create[s] substantive private rights.” Alexander, 532 U. S., at 290. The Act creates a reticulated remedial regime that both balances federal and state enforcement and channels disputes through that regime. Allowing §1983 suits will upend this careful balance.
Consider the remedial provisions that the Act provides. When federal officials find that a nursing home does not comply with FNHRA, the Act enumerates certain limited remedies they can pursue, such as withdrawing federal funding and imposing civil penalties “in an amount not to exceed $10,000 for each day of noncompliance.” §1396r(h)(3)(C). FNHRA obligates States to establish certain remedies for noncompliance (including civil penalties), but otherwise leaves them free to “specify criteria, as to when and how each of [the required] remedies is to be applied, the amounts of any fines, and the severity of each of these remedies, to be used in the imposition of such remedies.” §1396r(h)(2)(A). It also empowers States to “provide for other … remedies” as they see fit. Ibid. Finally, the Act provides “[s]pecial rules where [s]tate and [federal officials] do not agree on [a] finding of noncompliance.” §1396r(h)(6) (boldface deleted).
By specifying limited remedies for federal authorities and tasking States with otherwise determining the consequences for violations, the Act creates a clear division of authority that ensures States retain their historical control over nursing-home regulation. Allowing §1983 suits will upset this balance by allowing any plaintiff to demand damages regardless of the remedial regime that States establish pursuant to their explicit authority under the Act. Moreover, whenever a plaintiff files suit, the determination about ​noncompliance will be taken away from federal and state authorities and given to courts. And because the remedies offered under §1983 will often dwarf the relief available under FNHRA’s reticulated balance of remedies, §1983 will swallow the centralized state and federal review mechanisms the Act imposes.
The exclusivity of FNHRA’s enforcement regime is buttressed by the grievance remedy FNHRA gives to nursing-home residents. Residents have the “[r]ight to voice grievances with respect to treatment or care” and “the right to prompt efforts by the facility to resolve grievances.” §1396r(c)(1)(A)(vi). States, in turn, are obligated to “investigate complaints of violations of requirements by nursing facilities” and to take enforcement actions to correct those violations. §§1396r(g)(4), (h)(1); see also 42 CFR §483.10(j) (2021) (obligating States to provide a “grievance process” that includes a “written decision” in response to complaints that provides a full summary of findings, conclusions, and reasoning).
This grievance process dovetails neatly with FNHRA’s centralized enforcement regime because it funnels private complaints to the same state authorities that the Act tasks with enforcement. Indeed, respondent in this case wielded FNHRA’s grievance process to obtain relief for both of the rights petitioners allegedly violated. See App. to Pet. for Cert. 79a–80a. But because FNHRA’s remedies are more limited than the direct judicial highway that §1983 offers, it is hard to see why anyone would use them in the future. See Rancho Palos Verdes, 544 U. S., at 122–123.
The only textual evidence the majority can identify in response to this tailored remedial framework is FNHRA’s saving clause, which states that the Act’s remedies “are in addition to those otherwise available under State or Federal law.” §1396r(h)(8). But this provision only begs the question whether relief under §1983 is “otherwise ​available.” We have recognized as much when holding that a materially identical saving clause did not authorize implied remedies under a separate remedial provision. See AMG Capital Management, LLC v. FTC, 593 U. S. ___, ___–___ (2021) (slip op., at 12–13). And in the §1983 context, we have similarly held that saving clauses do “not ‘refer to a suit for redress of a violation of the statut[e] at issue.’ ” Rancho Palos Verdes, 544 U. S., at 126–127 (alterations omitted); accord, Sea Clammers, 453 U. S., at 20–21, n. 31.
These results are understandable. There is a considerable difference between preserving existing remedies for conduct that happens to violate other laws and providing a one-stop remedy for the precise provisions in a statute. See Alexander, 532 U. S., at 289–290. The latter interpretation runs against a century of holdings that a statute “ ‘cannot be held to destroy itself’ ” through a saving clause. American Telephone & Telegraph Co. v. Central Office Telephone, Inc., 524 U. S. 214, 227–228 (1998) (quoting Texas & Pacific R. Co. v. Abilene Cotton Oil Co., 204 U. S. 426, 446 (1907)). Conversely, concluding that FNHRA “may be enforced only through the statute’s express remed[ies]” gives full effect to §1396r(h)(8) because “the claims available under §1983 prior to the enactment of the [Act] continue to be available.” Rancho Palos Verdes, 544 U. S., at 126.
In short, “[a]llowing a plaintiff to circumvent [FNHRA’s] administrative remedies would be inconsistent with Congress’ carefully tailored scheme.” Smith v. Robinson, 468 U. S. 992, 1012 (1984). I would thus hold that the Act precludes enforcement under §1983 and reverse the judgment below. I therefore respectfully dissent.