Document ID: ./input/supremecourt_opinions/opinions/22pdf/21-806_2dp3.pdf
Page Number: 19.0

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

15 

Opinion of the Court 

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  unambigu-
ously confers rights upon the residents of nursing-home fa-
cilities. 

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  pur-
poses of discipline or convenience and not required to treat 
the  resident’s  medical  symptoms.”  §1396r(c)(1)(A)(ii)  (em-
phasis added).  The provision’s enumerated exceptions fur-
ther 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 Sec-
retary).  §§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 precondi-
tions  are  met,  including  advance  notice  of  the  transfer  or
family. 
discharge  to  the  resident  and  his  or  her 
§§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  im-
proved so much that the facility is no longer necessary; or if