Here's why Nancy Pelosi, Todd Rokita, Biden administration care about Indiana nursing home

Todd Rokita, Nancy Pelosi, the Biden Administration, dozens of current and former members of Congress — why are they all suddenly interested in a lawsuit involving a nursing home owned by Health & Hospital Corp. of Marion County?

On the surface, the case that surprisingly landed before the U.S. Supreme Court appears to center around an Indiana woman suing a Valparaiso nursing home for allegedly drugging her husband.

Marion County agency wants SCOTUS to strip protections for millions of vulnerable Americans

What's at stake, though, is much more. Justices will decide the fate of federal legal protections that a bi-partisan group of former members of Congress says are rooted in "arguably the most important civil rights statute in the history of the United States."

Related news:U.S. Supreme Court takes up case over care in nursing home owned by Marion County agency

The lawsuit started in a federal court in Indiana in 2019 but was appealed by the Health & Hospital Corp. of Marion County, which owns the nursing home, to the U.S. Supreme Court in 2021. When the justices agreed to review the case, it kicked off a flood of pleas from prominent politicians and organizations spanning the country and political spectrum. 

The vast majority are lining up against Marion County.

Of the 30 "friend of the court" briefs they've recently put in front of the U.S. Supreme Court for consideration, 25 argue people like Ivanka Talevski — the woman who sued — should be allowed to file a claim in court when rights granted through federal safety net programs such as Medicaid are at stake. 

In her lawsuit, Talevski said her husband, who had dementia, was illegally drugged and transferred to another nursing facility. Those actions fly in the face of rights granted to nursing home patients by the federal government, she argued.

Health & Hospital said its facility took those actions because her husband was being violent and sexually aggressive toward staff and other residents. The local government agency, which operates the Sidney & Lois Eskenazi Hospital and the county health department, has also quietly become the state's largest nursing home owner.

Opinion:Treatment of patient at Indiana nursing home at center of U.S. Supreme Court case

But while Talevski asked the county to financially compensate her family for the alleged misdeeds under federal nursing home law, the U.S. Supreme Court is going to review the broader question of whether she and others like her even have the right to file private lawsuits when terms of federal social welfare programs are violated by state and local governments.

That decision will likely set precedent and ripple throughout the country, which is why so many advocacy groups, academics and politicians are trying to get a seat at the table.

The final ruling — either way — will likely extend far beyond nursing home care to other federal programs such as the Children’s Health Insurance Program and Temporary Assistance for Needy Families, which aid millions of Americans.

Here's what they’re saying in court documents. 

Nancy Pelosi and members of Congress 

Nancy Pelosi and 14 other members of Congress say Talevski has the right to sue. That right is “essential for efficient administration and oversight” of federal safety net programs like Medicaid, they wrote. 

"Congress allocates billions of dollars each year in federal funds to assist the states in providing services for the nation’s most vulnerable individuals,” the members of Congress wrote. However, “neither federal nor state authorities have sufficient resources to provide complete oversight over the funding funneled into state programs.” 

“Both Congress and the states depend on private enforcement” in the form of lawsuits over alleged rights violations “to protect vulnerable individuals and groups.”  

More:Nursing home operator American Senior Communities to pay $5.5 million over Medicare fraud

A reversal of that norm would have “disastrous consequences” and “egregiously undermine Congress’ purpose in enacting these statutes,” the congressional members wrote. 

Todd Rokita and 21 other attorneys general  

Todd Rokita and attorneys general from 21 predominantly Republican states want the U.S. Supreme Court to side with Health & Hospital. 

They say that people like Talevski shouldn’t be able to sue because the federal government already has rules and regulations that govern state agencies that accept federal funds for safety net programs. There’s no concrete right to sue, they argue. 

Allowing these types of lawsuits “interferes with administration and enforcement mechanisms created by Congress,” and could impact states’ decision to accept those funds, they wrote. 

Either Congress creates a law that enshrines rights to sue these bad actors, the states wrote, “or they do not exist, period.” 

When people like Talevski are allowed to sue, it upsets “the reliance of states on the federal government’s capacity to negotiate and resolve disputes,” according to the states. 

“Political accountability … demands that the federal government be the one to decide” if a federal funding program's requirements have been violated, and “what the proper remedy is.” 

Ex-Congress members from both sides of the aisle

A bipartisan group of 34 former members of Congress wrote that this case touches on “arguably the most important civil rights statute in the history of the United States.” 

They were referring to what’s known as Section 1983, a federal law passed in the wake of the Civil War that gives Americans the ability to sue when their rights are being violated.

They asked the U.S. Supreme Court to side with Talevski. Lawsuits like hers, they say, create an extra layer of protection. 

“Congress has relied on this understanding of the law since at least the last forty years,” they wrote. “A step backward on this issue would put at risk the ability of millions of Americans who rely on (Section 1983) to protect themselves when state officials violate their federal rights.” 

Former U.S. health department officials 

Sixteen former senior officials of the Department of Health and Human Services, which oversees Medicaid, wrote that Health & Hospital is asking for drastic change. 

Barring people from enforcing their rights to Medicaid via lawsuits would be “at odds with HHS’s longstanding administrative practice,” the officials wrote. Beyond that, the restriction “would seriously undermine enforcement of one of the most important statutes protecting the rights of some of this nation’s most vulnerable individuals.” 

Federal regulations are already in place that guide how government can punish bad actors. But “private enforcement has played a crucial role in enforcing Medicaid’s key provisions,” the officials wrote. 

There’s also a potential conflict of interest when owners are required to police themselves, according to the ex-officials.

More:A woman was murdered at a troubled nursing home. The state let it expand a month earlier.

“States have demonstrated that they cannot function as reliable partners to enforce the federal mandate where they own or lease the very nursing homes subject to possible enforcement actions.” 

Indiana disability rights watchdog

“More than one million Hoosiers — and millions more nationwide — will be adversely affected” if the U.S. Supreme Court sides with Health & Hospital, according to Indiana Disability Rights, a federally mandated organization.  

The organization lists ten past incidences where people from vulnerable populations sued officials in Indiana for allegedly violating federal safety net programs. 

Without the right to sue, “affected beneficiaries would have (been) needlessly institutionalized, made to endure liver damage, and lose alimentary function," the organization wrote.

Investigation:Indiana nursing home patients suffer as Medicaid cash is diverted

“Given the critical nature of Medicaid benefits,” the organization continued, “several affected beneficiaries also likely would have died without needed services.” 

The Biden Administration

The Biden Administration says people can sue to enforce federal funding programs. But at the same time, it also wants the U.S. Supreme Court to reverse a lower court's decision that allowed Talevski’s suit to move forward.

In its court brief, the administration says it’s not taking sides in the case. Then it says past court cases and U.S. law have long established that people generally have a right to bring their complaints to a federal court when states violate the terms of safety net programs.  

However, that doesn’t apply to nursing home residents, the administration argues. Congress has already passed specific protections for those residents and created enforcement mechanisms through the Federal Nursing Home Reform Act of 1987, the court brief reads. 

Allowing Talevski the right to sue in this case “would be inconsistent with the (system) of administrative oversight and enforcement that Congress established," Solicitor General Elizabeth B. Prelogar wrote in her request to participate in oral arguments.  

State, local governments from across U.S. 

State, county and city government associations elsewhere in the U.S., including the National Conference of State Legislatures, are backing Health & Hospital. 

The associations wrote in a court brief that allowing private individuals the right to sue would “expose states to conditions unknown at the time they agreed to accept federal dollars.”  

More:IndyStar sues 8 hospitals for obscuring public spending data on nursing homes

“This is a serious problem,” the associations continued, “because a substantial portion of states’ revenue comes from federal grants, so the possibility of future private actions turns every federal dollar states accept into a litigation risk down the road.” 

“Faced with this prospect, some states may choose simply to opt out of receiving federal funds,” they wrote. “That would harm states — which use federal money for important purposes — as well as the federal government, which gives states money to promote important policy goals.” 

Academics from Yale, UCLA 

Forty academic leaders and scholars from universities like Yale and the University of California, Los Angeles want the U.S. Supreme Court to side with Talevski.  

“The Medicaid Act entitles the nation’s most vulnerable to health care,” they wrote in a court brief. “Yet decades of litigation show that states do not always recognize Medicaid beneficiaries’ rights." 

"Over the past half century, states unlawfully slashed coverage for pediatric health care services, … reduced benefits for children and adults with mental health issues or disabilities, ...and prevented low-income, working parents from accessing their rightful Medicaid benefits.” 

The ability to sue allows people like Talevski “to enforce the rights Congress guaranteed through the Medicaid Act," the academics wrote.

If Health & Hospital succeeds, “millions of Medicaid beneficiaries would be powerless to prevent states from slashing coverage and denying benefits, and states would no longer be subject to judicial oversight.” 

AARP 

The American Association of Retired Persons (AARP) also wants the U.S. Supreme Court to back Talevski’s right to sue.  

The foundation and a group of other advocates wrote that Congress passed landmark nursing home regulations in 1987 after a study found that “in too many nursing facilities, residents were being abused and neglected,” and received “’very inadequate — sometimes shockingly deficient — care.’” 

The Federal Nursing Home Reform Act “changed the federal government’s approach to protecting residents and improving their care” by giving nursing home residents a bill of rights and creating enforcement mechanisms that the government relies on to protect them.  

More:Threats of sexual assault, violence preceded nursing home resident's murder

But “even today, residents experience abuse, neglect, and dangerously poor care in many facilities … Given these dire conditions, residents must be able to enforce their FNRHA rights to protect themselves from persistent harm.” 

“Regulatory enforcement alone cannot do the job,” the advocacy groups wrote. 

“Even if regulatory enforcement functioned perfectly, which it does not, it still would not compensate residents for harms that result from facilities’ violating their rights.” 

Call IndyStar courts reporter Johnny Magdaleno at 317-273-3188 or email him at jmagdaleno@indystar.com. Follow him on Twitter @IndyStarJohnny