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12 

HEALTH AND HOSPITAL CORPORATION OF MARION 
CTY. v. TALEVSKI 
Opinion of the Court 

FNHRA is largely composed of a litany of statutory require-
ments  that  Congress  laid  out  for  Medicaid-participant
States and “nursing facilities.”  §1396a(a)(28).11  Those in-
clude  “[r]equirements  relating  to  residents’  rights,” 
§1396r(c)  (boldface  deleted),  two  of  which  Talevski’s  com-
plaint invoked.

The first requires nursing facilities to “protect and  pro-
mote” residents’ “right to be free from . . . any physical or 
chemical  restraints  imposed  for  purposes  of  discipline  or 
convenience and not required to treat the resident’s medical
symptoms.”  §1396r(c)(1)(A)(ii)  (referred  to  herein  as  “the
unnecessary-restraint provision”).  The second appears in a
subparagraph concerning “[t]ransfer and discharge rights,” 
§1396r(c)(2)(A)  (boldface  deleted),  and  tells  nursing  facili-
ties that they “must not transfer or discharge [a] resident” 
unless  certain  enumerated  preconditions,  including  ad-
vance notice of such a transfer or discharge, are met.  E.g., 
§§1396r(c)(2)(A)–(B)  (referred  to  herein  as  “the  predis-
charge-notice provision”).

As  for  enforcement,  like  other  aspects  of  Medicaid,  the
FNHRA  anticipates  “cooperative  federalism”—i.e.,  federal 
and  state  actors  working  together—to  carry  out  the  stat-
ute’s aims.  Wisconsin Dept. of Health and Family Servs. v. 
Blumer, 534 U. S. 473, 495 (2002).  Thus, qualifying State
Medicaid plans, which are approved by the Secretary of the 
U. S. Department of Health and Human Services (HHS Sec-
retary),  §1396a(b),  must  include  provisions  that  relate  to 
—————— 
to Title XIX of the Social Security Act, i.e., Medicaid.  See 101 Stat. 1330– 
182.  The FNHRA added a materially identical section to the Medicare-
focused portion of the Social Security Act, 101 Stat. 1330–160, 42 U. S. C.
§1395i–3 et seq.  Because Talevski’s complaint relies only on the Medi-
caid-related FNHRA provisions, App. to Pet. for Cert. 76a, we hereafter 
follow the parties and the Court of Appeals in referring only to the perti-
nent Medicaid provisions, as codified in the U. S. Code (§§1396a(a)(28), 
1396r). 

11 “Nursing  facility”  is  the  FNHRA’s  term  for  a  nursing  home. 

§1396r(a).