Anderson v. Dooley

Background

Bruce Anderson, John Wilson, Robert Austin, and California Advocates for Nursing Home Reform sued Mark Ghaly, in his official capacity as Secretary of the California Department of Health and Human Services, under 42 U.S.C. § 1983. They relied on provisions of the Federal Nursing Home Reform Act requiring a fair process for hearing appeals concerning transfers and discharges from skilled nursing facilities.

The resident plaintiffs alleged that they had won readmission hearings before California’s Department of Health Care Services but were not promptly returned to their facilities. They alleged that the state agencies responsible for the relevant programs disclaimed authority or responsibility to enforce the readmission decisions. They also alleged that a California law allowing residents to sue facility licensees did not provide an adequate remedy because residents generally could not afford counsel, state courts did not uniformly treat the administrative decisions as binding, and appeals could delay enforcement.

Prior Proceedings

The court had previously dismissed the complaint with prejudice after ruling that the relevant Federal Nursing Home Reform Act provisions did not create a private right enforceable through § 1983. The Ninth Circuit reversed that ruling, holding that the provisions did create such a right. But the Ninth Circuit also held that the original complaint did not plausibly allege a violation because it did not explain why California’s other legal or administrative mechanisms were insufficient to enforce favorable appeal decisions. The plaintiffs then filed an amended complaint.

Standing

The defendant argued that the plaintiffs lacked Article III standing, which requires a concrete injury, a connection between the injury and the challenged conduct, and a likelihood that a court decision would remedy the injury. The court rejected that argument as to the resident plaintiffs. It found that being kept in extended hospital stays, being unable to return to a desired nursing facility, and being transferred far from family were concrete and particularized injuries. Accepting the complaint’s allegations at this stage, the court found those injuries fairly traceable to the defendant’s alleged failure to require state agencies to enforce readmission orders and potentially remediable through the requested injunction.

Because the resident plaintiffs had standing, the court did not decide whether California Advocates for Nursing Home Reform also had standing.

Failure to State a Claim

The defendant argued that the amended complaint still failed to meet the Ninth Circuit’s requirements. The court disagreed. It held that the plaintiffs had alleged facts supporting their claim that California provided no effective state-agency or state-court mechanism for enforcing the Federal Nursing Home Reform Act right to an appeal, including implementation of a favorable decision.

The court relied on allegations that the Department of Health Care Services said it lacked authority to enforce its own orders and that the California Department of Public Health did not consider itself required to enforce hearing decisions concerning nursing-home evictions. The court also considered the plaintiffs’ allegations that the California private-action remedy was inadequate because of residents’ inability to afford counsel, uncertainty about whether state courts would treat readmission orders as binding, and the delay caused by appeals from injunctions.

The court stated that whether those allegations were true was a factual issue for discovery and possible summary judgment, not an issue to resolve on a motion to dismiss. Although the court found the plaintiffs’ requested declaratory and injunctive relief less than entirely clear, it held that the amended complaint plausibly alleged a violation of the Federal Nursing Home Reform Act’s appeals provision.

Primary Jurisdiction

The defendant alternatively asked the court to stay, or pause, the case under the primary-jurisdiction doctrine. That doctrine can allow a court to defer a judicial case while an agency with special expertise addresses an issue. The court declined to stay the case, concluding that the dispute concerned whether California’s enforcement mechanisms complied with the federal law and was not an unusually complicated issue committed to an agency.

Other Request and Disposition

The court denied as moot the defendant’s request for judicial notice because it did not consider the exhibits in deciding the motion. The court DENIED the defendant’s motion to dismiss and set a case-management conference for February 11, 2020. It directed the parties to file a joint case-management statement with a proposed schedule through trial.