Document ID: ./input/supremecourt_opinions/opinions/22pdf/21-806_2dp3.pdf
Page Number: 15.0

Cite as:  599 U. S. ____ (2023) 

11 

Opinion of the Court 

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  Con-
gress’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 pro-
vide quality services.  Yet, concerns about the poor condi-
tion of such facilities persisted even after Congress enacted
the 1965 Medicare and Medicaid Acts,9 partly due to wide-
spread 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  stand-
ards.  B.  Furrow,  T.  Greaney,  S.  Johnson,  T.  Jost,  &  R. 
Schwartz, Health Law 51 (3d ed. 2015) (Health Law).10  The 

—————— 

9 Medicare “provides Government-funded health insurance to” millions
of “elderly or disabled Americans,” while Medicaid “provides health in-
surance  to  all  low-income  individuals,  regardless  of  age  or  disability.” 
Becerra v. Empire Health Foundation, for Valley Hospital Medical Cen-
ter, 597 U. S. ___, ___–___ (2022) (slip op., at 2–3). 

10 The Omnibus Budget Reconciliation Act of 1987 added the FNHRA