Document ID: ./input/supremecourt_opinions/opinions/boundvolumes/529bv.pdf
Page Number: 97.0

529US1

Unit: $U32

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

22

SHALALA v. ILLINOIS COUNCIL ON LONG
TERM CARE, INC.
Opinion of the Court

and because the agency makes deﬁciency ﬁndings public on
the Internet, § 488.325.

The short, conclusive answer to these contentions is that
the Secretary denies any such practice. She states in her
brief that a nursing home with deﬁciencies can test the law-
fulness of her regulations simply by refusing to submit a plan
and incurring a minor penalty. Minor penalties, she says,
are the norm, for “terminations from the program are rare
and generally reserved for the most egregious recidivist in-
stitutions.” Reply Brief for Petitioners 18; ibid. (HHS re-
ports that only 25 out of more than 13,000 nursing homes
were terminated in 1995–1996). She adds that the “remedy
imposed on a facility that fails to submit a plan of correction
or to correct a deﬁciency—and appeals the deﬁciency—is no
different than the remedy the Secretary ordinarily would im-
pose in the ﬁrst instance.”
Ibid. Nor do the regulations
“cause providers to suffer more severe penalties in later en-
forcement actions based on ﬁndings that are unreviewable.”
Ibid. The Secretary concedes that a home’s deﬁciencies are
posted on the Internet, but she notes that a home can post
a reply. See id., at 20, n. 20.

The Council gives us no convincing reason to doubt the
Secretary’s description of the agency’s general practice. We
therefore need not decide whether a general agency prac-
tice that forced nursing homes to abandon legitimate chal-
lenges to agency regulations could amount to the “practi-
cal equivalent of a total denial of judicial review,” Haitian
Refugee Center, 498 U. S., at 497. Contrary to what Jus-
tice Thomas says, post, at 42–43, 51–52, we do not hold that
an individual party could circumvent § 1395ii’s channeling re-
quirement simply because that party shows that postpone-
ment would mean added inconvenience or cost in an isolated,
particular case. Rather, the question is whether, as applied
generally to those covered by a particular statutory pro-
vision, hardship likely found in many cases turns what ap-