Document ID: ./input/supremecourt_opinions/opinions/boundvolumes/529bv.pdf
Page Number: 124

529US1

Unit: $U32

[10-04-01 09:20:53] PAGES PGT: OPIN

Cite as: 529 U. S. 1 (2000)

49

Thomas, J., dissenting

enough that compliance with the challenged regulations
and manual is the more rational option. For one, nursing
homes face the prospect of termination—the most severe of
remedies—simply by virtue of failing to submit a voluntary
plan of correction and correct the deﬁciencies. See 42 CFR
§ 488.456(b)(1) (1998). The Secretary’s only response is that
terminations are rarely imposed in fact, and certainly are
not imposed where the provider has postponed correction
of its deﬁciencies in order to preserve its appeal rights. But
any such leniency is solely a matter of grace by the Secre-
tary, see Tr. of Oral Arg. 31, and provides little comfort to
a nursing facility pondering the § 1395cc(h) route to judicial
review. And exposure to the termination remedy is not the
only consequence faced by a nursing home that forestalls
correction of its deﬁciencies. The Secretary also may im-
pose civil monetary penalties, which accrue for each day
of noncompliance, 42 CFR §§ 488.430, 488.440(b) (1998), and
thus quite plainly stand as a calibrated deterrent to the for-
bearance strategy. Cf. Ex parte Young, 209 U. S. 123, 148
(1908) (“[T]o impose upon a party interested the burden of
obtaining a judicial decision . . . only upon the condition that
if unsuccessful he must suffer imprisonment and pay ﬁnes . . .
in effect, to close up all approaches to the courts”).12
is,
Other costs of the forbearance strategy are less tangible,
but potentially as signiﬁcant. For example, a ﬁnding of a
deﬁciency at a nursing facility—which may well rest on un-
balanced or inaccurate data—is posted in a place easily ac-
cessible to residents, 42 CFR § 483.10(g)(1) (1998), disclosed

12 In Thunder Basin Coal Co. v. Reich, 510 U. S. 200 (1994), the ag-
grieved mine operator was similarly subject to civil penalties ($5,000) for
each day of noncompliance with statutory provisions, which would become
ﬁnal and payable after review by the agency and the appropriate court of
appeals.
Id., at 204, n. 4, 218. But, unlike the nursing homes at issue
here, the aggrieved mine operator apparently had the option of complying
and then bringing a judicial challenge. See id., at 221 (Scalia, J., concur-
ring in part and concurring in judgment).