Document ID: ./input/supremecourt_opinions/opinions/22pdf/21-806_2dp3.pdf
Page Number: 17.0

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

13 

Opinion of the Court 

nursing facilities, and must require “any nursing facility re-
ceiving payments under” the plan to satisfy certain FNHRA
mandates.  §1396a(a)(28).  The  HHS  Secretary  must  also
“assure that” approved state plans—and “the enforcement
of [plan] requirements”—are, inter alia, “adequate” to “pro-
tect  the  health,  safety,  welfare,  and  rights  of  [nursing-
home] residents.”  §1396r(f )(1). 

The  FNHRA  also  establishes  a  detailed  administrative 
scheme  for  government  inspections  of  nursing  facilities. 
§1396r(g).  “Surveys”  (in  the  statute’s  parlance)  must  be
conducted to detect nursing homes that are falling short of
the  FNHRA’s  minimum  standards,  and  state  and  federal 
officials must periodically file certifications, based on these 
see 
surveys, 
§1396r(g)(1)(A).  In addition, the statute authorizes govern-
ment actors to sanction and correct noncompliant facilities, 
or, if appropriate, exclude them from the Medicaid program 
entirely.  §1396r(h); see also Health Law 56–63. 

regarding  nursing-home 

compliance, 

B 
1 
Although  federal  statutes  have  the  potential  to  create
§1983-enforceable rights, they do not do so as a matter of 
course.  For Spending Clause legislation in particular, we 
have recognized that “ ‘the typical remedy for state noncom-
pliance  with  federally  imposed  conditions  is not  a  private
cause of action for noncompliance but rather action by the
Federal  Government  to  terminate  funds  to  the  State.’ ” 
Gonzaga, 536 U. S., at 280 (quoting Pennhurst, 451 U. S., 
at 28).  The parties here thus dispute whether this is the 
atypical  case;  that  is,  whether  the  unnecessary-restraint 
and predischarge-notice provisions of the FNHRA “unam-
biguously  confe[r]”  individual  rights,  making  those  rights
“presumptively  enforceable”  under  §1983.    536  U. S.,  at 
283–284.