Page:Health and Hospital Corp. of Marion Co. v. Talevski.pdf/17

Rh nursing facilities, and must require “any nursing facility receiving 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 “protect 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 surveys, regarding nursing-home compliance, see §1396r(g)(1)(A). In addition, the statute authorizes government 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.

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 noncompliance 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 “unambiguously confe[r]” individual rights, making those rights “presumptively enforceable” under §1983. 536 U. S., at 283–284.