## Facts

- Gorgi Talevski, a nursing-home resident with dementia, lived at Valparaiso Care and Rehabilitation, a facility operated by a county health corporation and managed by a private contractor.
- The complaint alleged the facility administered psychotropic drugs as “chemical restraints” for discipline or convenience rather than to treat medical symptoms.
- The complaint also alleged the facility transferred and attempted to discharge him without meeting statutory preconditions and procedures and sought placement far from his family.
- Talevski, through his wife as next friend, sued under 42 U.S.C. § 1983, claiming the defendants deprived him of rights created by the Federal Nursing Home Reform Act (FNHRA), including:
  - the right to be free from unnecessary chemical restraints; and
  - rights limiting transfer and discharge absent specified conditions and process.
- The district court dismissed under Rule 12(b)(6), concluding the invoked FNHRA provisions did not create rights enforceable through § 1983.

## Issues

1. Whether the FNHRA provisions guaranteeing (a) freedom from unnecessary chemical restraints and (b) limits and procedures for transfer/discharge create individual federal rights enforceable under 42 U.S.C. § 1983.
2. If those provisions create enforceable rights, whether FNHRA’s enforcement mechanisms show congressional intent to preclude § 1983 suits.

## Decision

- The Seventh Circuit reversed the dismissal and remanded.
- It held the two invoked FNHRA provisions unambiguously confer individual rights on nursing-home residents and are presumptively enforceable under § 1983.
- It further held FNHRA’s text, structure, and enforcement mechanisms do not show congressional intent to foreclose § 1983 enforcement of those rights.

## Legal Principles

- Section 1983 provides a cause of action for violations of federal statutory rights as well as constitutional rights.
- A federal statute creates a right enforceable under § 1983 when the provision:
  - is intended to benefit the plaintiff;
  - states a specific, definite entitlement capable of judicial enforcement (not “vague and amorphous”); and
  - imposes a binding obligation in mandatory terms.
- Rights-creating language focused on “the persons benefited,” including explicit statements that a “resident has the right,” supports finding an enforceable individual right.
- Even when a statute creates enforceable rights, § 1983 is unavailable only if Congress expressly or impliedly displaced it through an incompatible, comprehensive remedial scheme.
- The Spending Clause character of Medicaid-related legislation does not categorically bar § 1983 enforcement; enforceability turns on the rights-creation analysis and any indication of congressional foreclosure.

## Conclusion

The Seventh Circuit held that FNHRA’s protections against unnecessary chemical restraints and against improper transfer or discharge confer individual rights that nursing-home residents may enforce through § 1983, and it allowed the resident’s claims to proceed because FNHRA does not preclude that remedy.


Talevski v. Health & Hosp. Corp. of Marion Cnty., 6 F.4th 713 (7th Cir. 2021)