Indiana case at U.S. Supreme Court could affect millions of Americans

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.

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.”

The Indiana Capital Chronicle is an independent, not-for-profit news organization that covers state government, policy and elections.

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3 thoughts on “Indiana case at U.S. Supreme Court could affect millions of Americans

  1. Health and Hospital Corp.

    Lynne Arrowsmith
    2:52 PM (27 minutes ago)
    to lettertoeditor

    I would like to see an article which details how and why the Marion County Health and Hospital Corp was formed. How it is structured, who are the employees and their salaries, who are the board members, who appoints them, etc. What is its mission, charter, purpose, bylaws?

    Also, do other cities have similar corporations to manage public health services and facilities?

    Given H&H Corp’s recent legal maneuvers, it is hard to see how it serves the needs of the public, of the residents of Marion County.
    It appears to be purely a moneymaking entity without any goals of improving public health or of providing quality health care .In fact, it’s use of Medicare funds is dragging down the level of health care at nursing homes throughout Indiana.
    A thorough investigation with full disclosure to the public is needed

    Ideally, the case which is to be heard by the US Supreme Court should be withdrawn immediately, too.
    I am very surprised that SCOTUS would take this case in which a government entity is seeking to reduce its obligations and responsibility to the people who are their employees, i.e. the tax payers.

  2. What Hoosier would want to be “cared for” in a nursing home owned on paper by the HHC of Marion County where some significant portion of the Medicare funds received from Washington are siphoned off to pay for the shiny new Eskinazi county hospital in Indianapolis? It’s really disgraceful how HHC is essentially scamming federal taxpayers by receiving larger Medicare reimbursements for nursing homes all the while paying American Senior Communities to run them as cheaply as possible. If you’re not aware, it’s my understanding that Medicare reimburses public owners of nursing homes at a slightly higher rate than private operators, presumably on the premise that a public owner will have higher costs than a private owner.

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