Document ID: ./input/supremecourt_opinions/opinions/22pdf/21-806_2dp3.pdf
Page Number: 35

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

3 

THOMAS, J., dissenting 

to residents’ rights,” the Act requires recipients to “protect
and  promote  the  rights  of  each  resident,”  including  “[t]he
right to choose a personal attending physician” and make
informed  medical  decisions;  “[t]he  right  to  be  free  from 
physical  or  mental  abuse,  corporal  punishment,  involun-
tary seclusion, and any [medically unnecessary] physical or 
chemical  restraints”;  and  “[t]he  right[s]  to  privacy”  and 
“confidentiality.”  42  U. S. C.  §§1396r(c)(1)(A)(i)–(iv).    The 
Act further provides that funding recipients “must permit
each resident to remain in the facility and must not transfer 
or discharge the resident” without cause.  §1396r(c)(2)(A).
Recipients must also adopt procedures for residents to as-
sert these “rights” and to otherwise “voice grievances with
respect to [their] treatment or care.”  §1396r(c)(1)(A)(vi).

The  Act  also  imposes  many  requirements  directly  and 
uniquely upon participating States, including in a subsec-
tion entitled “State requirements relating to nursing facil-
ity requirements.”  §1396r(e).  For instance, States must es-
tablish  procedures  for  residents  to challenge  transfer  and 
discharge decisions and an appeals process for other deter-
minations.  §§1396r(e)(3) and (e)(7)(F).  States are also re-
quired  to  certify  non-state-run  facilities’  compliance  with 
the  Act’s  provisions  by  conducting  annual  surveys  using 
protocols developed by the Secretary of Health and Human
Services.  §1396r(g)(2)(A).  If a State finds that a facility is 
not providing adequate care, it must conduct an extended 
survey.  §1396r(g)(2)(B).  The Act also requires States to in-
vestigate resident complaints and perform onsite monitor-
ing at previously noncompliant or potentially noncompliant 
facilities.  §1396r(g)(4)(B).  And, if it finds a violation that 
“jeopardize[s] the health or safety of [a facility’s] residents, 
the State shall take immediate action to remove the jeop-
ardy and correct the deficiencies.”  §1396r(h)(1)(A).1 

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1 This  survey  merely  scratches  the  surface  of  the  requirements  that 
FNHRA  imposes  upon  participating  States.    See  also,  e.g.,  42  U. S. C.