Page:Health and Hospital Corp. of Marion Co. v. Talevski.pdf/73

Rh noncompliance will be taken away from federal and state authorities and given to courts. And because the remedies offered under §1983 will often dwarf the relief available under FNHRA’s reticulated balance of remedies, §1983 will swallow the centralized state and federal review mechanisms the Act imposes.

The exclusivity of FNHRA’s enforcement regime is buttressed by the grievance remedy FNHRA gives to nursing-home residents. Residents have the “[r]ight to voice grievances with respect to treatment or care” and “the right to prompt efforts by the facility to resolve grievances.” §1396r(c)(1)(A)(vi). States, in turn, are obligated to “investigate complaints of violations of requirements by nursing facilities” and to take enforcement actions to correct those violations. §§§ [sic]1396r(g)(4), (h)(1); see also 42 CFR §483.10(j) (2021) (obligating States to provide a “grievance process” that includes a “written decision” in response to complaints that provides a full summary of findings, conclusions, and reasoning).

This grievance process dovetails neatly with FNHRA’s centralized enforcement regime because it funnels private complaints to the same state authorities that the Act tasks with enforcement. Indeed, respondent in this case wielded FNHRA’s grievance process to obtain relief for both of the rights petitioners allegedly violated. See App. to Pet. for Cert. 79a–80a. But because FNHRA’s remedies are more limited than the direct judicial highway that §1983 offers, it is hard to see why anyone would use them in the future. See Rancho Palos Verdes, 544 U. S., at 122–123.

The only textual evidence the majority can identify in response to this tailored remedial framework is FNHRA’s saving clause, which states that the Act’s remedies “are in addition to those otherwise available under State or Federal law.” §1396r(h)(8). But this provision only begs the question whether relief under §1983 is “otherwise