Indiana case – now at the Supreme Court — could impact millions of vulnerable Americans

A public health agency argues that nursing home patients shouldn’t be able to sue the facilities for civil rights violations

By: - October 12, 2022 7:00 am

Advocates for the elderly, poor and people with disabilities say a local legal challenge going to the U.S. Supreme Court could severely threaten federal benefit programs, like Medicaid. (Getty Images)

As the U.S. Supreme Court prepares to hear oral arguments in an Indiana case that could have national implications for millions of Americans participating in federal safety net programs, pressure is mounting locally for the public health agency at the heart of the legal battle to withdraw the case altogether.

Advocates for the elderly, poor and people with disabilities say the legal challenge could severely threaten federal benefit programs, like Medicaid. 

A decision from the high court could federalize most medical malpractice litigation and such policy at the state level. That means patients could lose their ability to sue over poor care.

What’s at stake

Up for debate is a lawsuit — Health and Hospital Corporation of Marion County v. Talevski — originally filed in federal court in Indiana in 2019 by the estate of Gorgi Talevski, who resided in Indiana before he died. 

The court filing alleged that Talevski was chemically restrained and medicated so that he would go to sleep instead of being treated for his dementia while living in a Valparaiso nursing home. 

Talevski’s wife, Ivanka, additionally maintained that her husband was illegally transferred to another nursing facility – which she argued is a violation of federal rights granted to nursing home patients.

The lower court determined that Talevski’s estate could sue under the Nursing Home Reform Act provisions of Medicaid, but that decision was appealed by the Health & Hospital Corp. of Marion County (or HHC), which owns the nursing home where Talevski received care. The local government agency operates the Sidney & Lois Eskenazi Hospital in Indianapolis, as well as the Marion County Health Department. It’s also the state’s largest nursing home owner, operating 78 facilities across Indiana.

A negative ruling will leave them without legal recourse if they face mistreatment or abuse or their benefits are taken away or denied.

– Arc of Indiana

HHC said its facility took necessary actions, noting that Talevski was violent and sexually aggressive toward staff and other residents.

But HHC went even farther, arguing that residents of publicly owned, Medicaid-funded nursing homes should not be allowed to sue the facilities for violating their civil rights.

The high court justices agreed to review the case. Oral arguments are scheduled for Nov. 8. 

It will then be up to the justices to decide whether beneficiaries of programs like Medicaid have the right to sue state and local governments, or have any form of recourse at all if their civil rights are violated.

Advocates push for HHC to drop the case

Former members of Congress and past U.S. health department officials are among the dozens of entities that have filed briefs in support of Talevski’s wife and her right to to file a claim in court.

Current members of Congress said in their brief, too, that the right to sue is “essential for efficient administration and oversight” of federal safety net programs like Medicaid. Reversing that right would have “disastrous consequences,” they said.

“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. “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 of rights encapsulated in these statutes to protect vulnerable individuals and groups.”

No Indiana members signed on to the brief, however.

But Republican Indiana Attorney General Todd Rokita and attorneys general from 21 other states filed a separate brief, siding with HHC.

They maintain lawsuits like Talevski’s “interfere(s) with administration and enforcement mechanisms created by Congress,” and could make states hesitant to accept federal funds. The AGs added that the federal government already has regulations in place for state agencies that accept federal dollars for safety net programs.

The Arc of Indiana, an advocacy group for people with intellectual and developmental disabilities, along with 91 other state and national advocacy organizations for vulnerable populations, are now urging the HHC board to withdraw the Supreme Court case.

The advocates emphasized that federal safety net programs have been a “lifeline for millions of people,” especially those with disabilities. Specifically, they point to Medicaid, the Supplemental Nutrition Assistance Program (SNAP), the Children’s Health Insurance Program (CHIP), and Temporary Assistance to Needy Families (TANF).

“One in four adults in Indiana has a disability, and many of them rely on these programs to live full and active lives,” the Arc of Indiana said in a news release. “Private lawsuits – often brought by The Arc and our partners – have often been the only recourse for people to get the services and services and supports they need. A negative ruling will leave them without legal recourse if they face mistreatment or abuse or their benefits are taken away or denied.”

The group is calling for the HHC board to re-examine the case at its Oct. 18 meeting. It’s not yet clear whether the board will address the lawsuit in its public agenda.

The seven-member HHC board is appointed by the Democratic-led offices of the Indianapolis mayor, City-County Council and Marion County Board of County Commissioners.

The agency’s president and CEO, Paul Babcock, did not respond to a request for comment. He told The Indianapolis Star that his legal team maintains the Federal Nursing Home Reform Act doesn’t include a “private right of action to sue nursing homes or nursing home operators.”

Last month, Babcock said during a public meeting that nursing home patients have “a whole host of other remedies” for holding health facilities accountable, including filing a complaint with the Indiana Department of Health.

“We’re continuing to always be concerned with care in our nursing homes … if (HHC) prevails in this case, that care level will not change,” he said. “I do not believe that rights will be lost.”


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Casey Smith
Casey Smith

A lifelong Hoosier, Casey Smith previously reported on the Indiana Legislature for The Associated Press. Internationally, she has reported on water quality across South America. She holds a master’s degree in investigative reporting and narrative science writing from the University of California/Berkeley’s Graduate School of Journalism. She previously earned degrees in journalism, anthropology and Spanish from Ball State University, where she now serves as an instructor of journalism.